my personal edition > schizophrenia > news


  E-Mail this DGNews to a colleague

DGNews

Comparative Study Shows Differences Between Atypical Antipsychotic Medications Geodon (Ziprasidone) and Zyprexa (Olanzapine)

LOS ANGELES, CA -- October 12, 2004 -- A double-blind study of two commonly used atypical antipsychotic medications-ziprasidone (brand name: Geodon) and olanzapine (brand name: Zyprexa)-has found that while the two drugs appear to be equally effective in the treatment of schizophrenia, they have markedly different effects on such metabolic markers as body weight, triglyceride levels, and cholesterol levels.

The study, led by George Simpson, M.D., interim chair of the Department of Psychiatry and Behavioral Sciences at the Keck School of Medicine of the University of Southern California, is the first randomized, double-blind comparison of the two drugs, and appears in this month's issue of The American Journal of Psychiatry.

In this six-week, multi-center study, 269 patients with diagnoses of schizophrenia or schizoaffective disorder who had been recently admitted to any of three different medical centers (including LAC+USC Medical Center in Los Angeles, Stanford University, and SUNY Health Science Center in Brooklyn, New York) were randomly given either ziprasidone or olanzapine over six weeks to treat their symptoms. (The doses were flexible, the researchers noted, "allowing investigators to dose according to clinical judgment within the permissible range.")

Patients in both groups showed significant reduction in schizophrenic symptoms, but there was no significant difference in the reduction between the groups.

There were, however, significant differences in the effects on the drugs on various measures of metabolism. For instance, patients receiving olanzapine increased their body weight by a mean of 7.9 pounds, while the patients in the ziprasidone group gained a mean of 2.1 pounds. The olanzapine patients saw their cholesterol rise by a mean of 19.5 milligrams per deciliter (mg/dL) and their triglycerides go up by a mean of 26 mg/dL, while those on ziprasidone actually saw a decrease, with a mean of -1 mg/dL in cholesterol, and a mean of -2 mg/dL in triglycerides.

In addition, insulin levels rose a mean of 33.7 percent over the treatment period in olanzapine patients, in contrast to a less-than 3 percent increase in ziprasidone patients.

These differences are important, Simpson says, given increasing attention and concern about the links between the entire class of atypical antipsychotics-also known as second-generation antipsychotics, a class of drugs that seems to have a decreased risk of causing the severe movement disorders found in the first-generation, or typical, antipsychotics-and obesity, cholesterol and triglyceride levels, and diabetes.

"Given that antipsychotic medications are often required for many years-indeed, over a lifetime for some patients-it's important to be able to inform patients about potential long-term risks, such as heart disease and diabetes," Simpson notes. "Our short-term study showed clear weight and metabolic differences between ziprasidone and olanzapine that should be considered in selecting an appropriate treatment for the long-term management of patients."

The next step, Simpson says, is to compare ziprasidone and olanzapine over a longer period of time. "Additional controlled studies are needed to evaluate the efficacy and tolerability of ziprasidone versus olanzapine in longer-term treatment and to determine whether the differences between these agents with regard to weight gain and lipid and insulin alterations are sustained and likely to influence general health status," the researchers note in their study.

This work was sponsored by Pfizer Inc., which markets ziprasidone as Geodon.



SOURCE: University of Southern California, Los Angeles

E-Mail this DGNews to a colleague

To print, use this version