Original ContributionsMetabolic Effects of Olanzapine in Patients With Newly Diagnosed PsychosisFernandez-Egea, Emilio MD*; Miller, Brian MD, MPH†; Garcia-Rizo, Clemente MD‡; Bernardo, Miguel MD, PhD§∥¶; Kirkpatrick, Brian MD# Author Information From the *Department of Psychiatry, University of Cambridge, Cambridgeshire and Peterborough Mental Health Trust, United Kingdom; †Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta, GA; ‡Schizophrenia Clinic Program, Neuroscience Institute, Hospital Clinic of Barcelona, §Department of Psychiatry and Clinical Psychobiology, University of Barcelona, and ∥Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona; and ¶Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; and #Department of Psychiatry and Behavioral Science, Texas A&M Health Sciences Center, Temple, TX. Received July 15, 2010; accepted after revision January 11, 2011. Reprints: Brian Miller, MD, MPH, Department of Psychiatry and Health Behavior, Medical College of Georgia, 997 St Sebastian Way, Augusta, GA 30912 (e-mail: [email protected]). Supported in part by NIH grant 5R01DK069265-05 (to B.K.) and the Government of Catalonia, Comissionat per Universitats i Recerca del Departament d'Innovació, Universitats i Empresa (DIUE) 2009SGR1295 (to M.B.). The data have previously been presented as a poster at the 49th Annual NIMH New Clinical Evaluation Drug Unit meeting, June 29-July 2, 2010, Hollywood, Florida (by B.M.). Trial Registration: ClinicalTrials.gov Identifier: NCT00446992. Journal of Clinical Psychopharmacology: April 2011 - Volume 31 - Issue 2 - p 154-159 doi: 10.1097/JCP.0b013e31820fcea3 Buy Metrics Abstract Antipsychotic medications are associated with an increased risk of diabetes. Previous studies have also found an increased risk of type 2 diabetes mellitus in the relatives of schizophrenia probands. The aim of this study was to explore the metabolic adverse effects of olanzapine in a cohort of patients with newly diagnosed psychosis and minimal or no exposure to antipsychotics. Patients with newly diagnosed psychosis (n = 30) were enrolled in a 16-week open trial of olanzapine. Body mass index, fasting glucose, hemoglobin A1c, fasting insulin, IL-6, and a fasting lipid profile were measured at baseline and at 4-week intervals. There was a significant, linear increase over time in fasting glucose (P = 0.043), weight (P < 0.001), body mass index (P < 0.001), total cholesterol (P = 0.005), triglycerides (P = 0.003), and low-density lipoprotein (P = 0.013), but not hemoglobin A1c (P = 0.691), fasting insulin (P = 0.690), IL-6 (P = 0.877), or high-density lipoprotein (P = 0.446). An abnormal baseline IL-6 was a significant predictor of a greater increase in both total cholesterol (P < 0.01) and low-density lipoprotein (P < 0.01). Otherwise, neither parental history of type 2 diabetes mellitus nor baseline IL-6 predicted changes in metabolic measures. Changes in metabolic measures with olanzapine treatment can be detected early in the treatment of patients who are previously antipsychotic naive. The absence of a change in fasting insulin suggests a failure of pancreatic islet cells to compensate for the increase in fasting glucose. © 2011 Lippincott Williams & Wilkins, Inc.