정신분열병 환자에게서 12주간 지프라시돈과 리스페리돈 투여에 의한 체중 증가 및 대사성 부작용 비교

Abstract

Objective：Body weight gain and metabolic syndrome are frequent adverse side effects of atypical antipsychotics. However, ziprasidone has been reported to have less effect on body weight and other metabolic parameters of patients, such as blood glucose and cholesterol. In this study, changes in the body weight and metabolic parameters were compared between the treatment groups of ziprasidone and risperidone in the patients with schizophrenia or schizoaffective disorder. Methods：Patients shown acute exacerbation of schizophrenia or schizoaffective disorder diagnosed by DSM-IV diagnostic criteria were randomly assigned to ziprasidone 40-80 ㎎ b.i.d. (N=56) or risperidone 1-4 ㎎ b.i.d. (N=56) for 12 weeks. Body weight was measured before treatment and at 1st, 2nd, 4th, 6th, 12th week after treatment. The serum levels of glucose and cholesterol were checked before treatment and 12th week after treatment, and serum levels of prolactin before treatment and at 4th and 12th week after treatment. Results：Less gain of body weight was shown in the patients treated with ziprasidone compared to those treated with risperidone. Mean body weight gain for 12 weeks were 0.8 ㎏ and 3.5 ㎏ in the ziprasidone and risperidone group, respectively. There was significant difference in weight gain between these two groups from 4th week. Serum prolactin elevation was higher in the risperidone group than in the ziprasidone group. However, there were no significant differences in the effects on the level of blood glucose and cholesterol between two treatment groups. Conclusion：This study shows that ziprasidone had less effect on body weight and prolactin compared to risperidone in the patients with schizophrenia or schizoaffective disorder in Korea. Although further studies are necessary to investigate the long-term effects, the less effect of ziprasidone on body weight and serum prolactin in schizophrenia and schizoaffective patients in Korea may help to enhance treatment compliance and lessen the cardiovascular risks.