Aripiprazole and Risperidone Present Comparable Long-Term Metabolic Profiles: Data From a Pragmatic Randomized Controlled Trial in Drug-Naïve First-Episode Psychosis
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Objective: Aripiprazole and risperidone are 2 of the most used second-generation antipsychotics (SGAs) worldwide. Previous evidence shows a similar effect of these SGAs on weight and metabolic changes in the short term. However, a longer period is necessary for a better assessment of the SGA´s metabolic profile. We aimed to compare the long-term (1-year) metabolic profile of these 2 antipsychotics on a sample of drug-naïve first episode-psychosis (FEP) patients. Methods: A total 188 drug-naïve patients, suffering from a first episode of non-affective psychosis (FEP), were randomly assigned to treatment with either aripiprazole or risperidone. Weight and glycemic/lipid parameters were recorded at baseline and after 1-year follow-up. Results: We observed significant weight increments in both groups (9.2 kg for aripiprazole and 10.5 kg for risperidone) after 1 year of treatment. Despite this, weight and body mass index changes did not significantly differ between treatment groups (P > .05). Similarly, both treatment groups presented similar metabolic clinical impact with a comparable increase in the proportion of participants meeting criteria for metabolic disorders such as obesity or hypercholesterolemia, but not for metabolic syndrome (Δ9.2% vs Δ4.3%) or hypertriglyceridemia (Δ21.9% vs Δ8.0%), where aripiprazole showed worse outcomes than risperidone. Conclusion: This study shows that aripiprazole and risperidone share a similar long-term metabolic profile. After 1 year of antipsychotic treatment, drug-naïve FEP patients in both treatment groups presented a significant increase in weight and metabolic changes, leading to a greater prevalence of metabolic disorders.
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Data from drug naïve patients with psychosis showed significant weight and metabolic changes after one year of treatment with either risperidone or aripiprazole.
“Data from drug naïve patients with psychosis showed significant weight and metabolic changes after one year of treatment with either risperidone or aripiprazole [142].”
From Pharmacological treatment in autism: a proposal for guidelines on common co-occurring psychiatric symptoms (2025) · cites this paper as [142]
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Update on weight-gain caused by antipsychotics: a systematic review and meta-analysis
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“According to a recent systematic review and metaanalysis (Barton et al., 2020), although all antipsychotic groups (including aripiprazole and risperidone) significantly increased weight gain, aripiprazole did not cause clinically significant weight gain.”
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Manter, M. A., Birtwell, K. B., Bath, J., Friedman, N. D. B., Keary, C. J., Neumeyer, A. M., Palumbo, M. L., Thom, R. P., Stonestreet, E., Brooks, H., et al. (2025) · BMC Medicine · doi:10.1186/s12916-024-03814-0 · Cited by 51 · see citing works
“Data from drug naïve patients with psychosis showed significant weight and metabolic changes after one year of treatment with either risperidone or aripiprazole [142].”
- Authors
- Vázquez-Bourgon, J., Ortiz-García de la Foz, V., Gómez-Revuelta, M., Mayoral-van Son, J., Juncal-Ruiz, M., Garrido-Torres, N., & Crespo-Facorro, B.
- Affiliations
- Department of Psychiatry, University Hospital Marqués de Valdecilla - Instituto de Investigación Marqués de Valdecilla (IDIVAL) , Santander , Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM) , Sevilla , Spain
- Department of Medicine and Psychiatry, School of Medicine, Universidad de Cantabria , Santander , Spain
- ORCID
- Venue
- International Journal of Neuropsychopharmacology
- Publisher
- Oxford University Press (OUP)
- Published
- 2022-05-31
- Volume
- 25
- Issue
- 10
- Pages
- 795-806
- ISSN
- 1461-1457 (ISSN-L)
- 1469-5111
- PMC
- PMC9593219
- OpenAlex
- W4281608449
- Cited by
- 18
- References
- 7
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 4 · 2023: 4
- FWCI
- 2.61
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- The International Journal of Neuropsychopharmacology (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DIGITAL.CSIC (Spanish National Research Council (CSIC)) (acceptedVersion, other-oa)
- RISalud Institutional Health Repository of Andalucía (submittedVersion, cc-by-nc)
- Deposito de Investigacion Universidad de Sevilla (University of Seville) (submittedVersion, cc-by-nc)
- UCrea (University of Cantabria) (submittedVersion, cc-by-nc)
- Funders
- Instituto de Investigación Sanitaria Valdecilla (INT/A20/04, INT/A21/10)
- Instituto de Salud Carlos III (PI020499, PI050427, PI060507)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- aripiprazole, risperidone, first-episode psychosis, atypical antipsychotics, weight gain, metabolic syndrome, hypertriglyceridemia, hypercholesterolemia, obesity, drug-naive patients
- MeSH terms
- Aripiprazole, Humans, Lipids, Psychoses, Substance-Induced, Psychotic Disorders, Antipsychotic Agents, Risperidone, Metabolome
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