Determination and prediction of risks being obesity and diabetes mellitus treatment of schizophrenic patients by atypical antipsychotics

Atypical antipsychotics are used as first-line treatment of schizophrenia, because of less side effects of extrapyramidal tract and having effect on negative symptoms comparing to typical antipsychotics. However, atypical antipsychotics show side effects of body weight gain and impaired glucose tolerance. We studied effects of olanzapine and blonanserine on schizophrenic patients with indices of changes of blood adiponectine and retinol binding protein 4 (RBP4). Adiponectine shows activities of antidiabetes, antiarteriosclerosis and antiinflammation and the blood protein contents are reduced by impaired of lipid metabolism. On the other hand, RBP4 increases an insulin resistant and the blood protein concentration is increased by the lipid metabolism abnormality. Drugs are prescribed to the patients with clinical dosage regimen and combination of antipsychotic is avoided. By a treatment of olanzapine, time course change of adiponectine and RBP4 showed mirror image, i.e. adiponectine increased and RBP4 decereased at initial treatment and then went recovering with the time of treatment. Blonanserine did not show clear influence to these proteins. Olanzapine increased body weight and BMI with treating after 14 weeks, while blonanserine did not. Urine C-peptide concentration reflecting a secretion of insulin was markedly decreased by olanzapine, while slightly decreased by blonanserine. However, there were no significant difference between olanzapine and blonanserine on the effect of urine C-peptide consentration. Blood glucose level, % of hemoglobine Alc and % of glycoalbumine were not changed by both antipsychotics. These results possibly indicate that olanzapine increases body weight and BMI with worsening lipid metabolism and also impairs glucose torelability by reducing insulin secretion, while blonanserine did not show clear influence on lipid metabolism and glucose torelability.