A study on haloperidol and risperidone induced metabolic derangements in patients with newly diagnosed schizophrenia

BACKGROUND: The occurrence of metabolic abnormalities in schizophrenic patients has been increasing with the use of second generation antipsychotics. AIM AND OBJECTIVE: To compare the metabolic derangements induced by one of the typical antipsychotic – Haloperidol and an atypical antipsychotic – Risperidone in patients with newly diagnosed schizophrenia in a tertiary care hospital. METHODOLOGY: The study was conducted in department of Psychiatry in collaboration with Institute of Pharmacology and Department of Biochemistry, Government Rajaji Hospital, Madurai from December 2014 to June 2016 after obtaining ethical clearance from the Institutional ethical committee, Government Rajaji Hospital, Madurai (Letter no 13432/E1/5/2014). 60 patients with newly diagnosed schizophrenia were selected based on eligibility criteria. The anthropometric measurements like height, weight, waist circumference were measured and body mass index was calculated. Out of 60 patients, 30 patients received tablet haloperidol and the remaining 30 patients received tablet risperidone orally. Blood samples were taken for the parameters like fasting blood glucose level and fasting lipid profile at baseline, at the end of 3 and 6 months of drug therapy. The metabolic derangements induced by the two antipsychotics in these patients were compared at end of 3rd and 6th month using students t test in SPSS 16 statistical software. RESULTS: All the patients were followed up till the end of the study. There were no dropouts. Out of sixty patients who participated in the study, 45% were males and 55% were females. At the end of 6th month statistically significant differences (p<0.05) were observed in weight, waist circumference, fasting blood sugar, fasting triglyceride and high density lipoprotein level between the haloperidol and risperidone group on following the IDF criteria of metabolic syndrome. Risperidone caused metabolic abnormalities in 13.3% patients whereas none of the patients in haloperidol group developed metabolic syndrome. CONCLUSION: Hence it is concluded that the atypical antipsychotic risperidone has been associated with an increased risk of causing metabolic abnormalities than the typical antipsychotic haloperidol.Regular and periodic monitoring of the anthropometric and metabolic parameters in schizophrenic patients on antipsychotics especially the atypical antipsychotics is mandatory to prevent further complications.