Schizophrenia Clinical Trial
Official title:
Glucose Regulation During Ziprasidone Treatment
Abnormalities in peripheral glucose regulation and type 2 diabetes can occur more commonly in individuals with schizophrenia than in healthy subjects or in other psychiatric conditions. Antipsychotic treatment may contribute significantly to abnormalities in glucose regulation. Hyperglycemia can contribute to long-term cardiovascular disease risk that may already be increased in patients with schizophrenia due to higher rates of smoking, sedentary life style, obesity and under-treated hypertension and dyslipidemia. This project will characterize the effects on glucose control of the two most commonly prescribed newer antipsychotic medications, ziprasidone and olanzapine, in patients with schizophrenia.
This proposal aims to use a well-characterized procedure, the modified Frequently Sampled
Intravenous Glucose Tolerance Test (FSIGTT), to characterize the glucoregulatory effects of
the two most commonly prescribed atypical antipsychotic medications, ziprasidone and
olanzapine, in comparison to the conventional antipsychotic haloperidol. Abnormalities in
peripheral glucose regulation and type 2 diabetes can occur more commonly in individuals
with schizophrenia than in healthy subjects or in other psychiatric conditions. While
abnormalities in glucose regulation were first reported in schizophrenia prior to the
introduction of antipsychotic medications, antipsychotic treatment may contribute
significantly to abnormalities in glucose regulation.
Recently, the adverse effect of antipsychotic medications on systemic glucose regulation has
received increased attention as investigators noted prominent adverse glucoregulatory
effects associated with certain newer antipsychotic medications. Abnormal glucose regulation
and new-onset type 2 diabetes have been reported during clozapine and olanzapine treatment.
Complicating the study of antipsychotic-induced changes in glucose regulation, increased
adiposity can decrease insulin sensitivity, and antipsychotics can increase adiposity and
body mass index (BMI). However, abnormal glucose regulation and type 2 diabetes can occur
during clozapine treatment in the absence of weight gain, suggesting that changes in glucose
regulation can occur independent of drug-induced increases in BMI. Consistent with this, our
preliminary studies indicate that important effects of clozapine and olanzapine on glucose
regulation are not accounted for by differences in BMI. This proposal will compare the
effects of olanzapine, ziprasidone and haloperidol on well-defined measures of glucose
regulation.
This proposal specifically hypothesizes that olanzapine treatment will be associated with
decreases in insulin sensitivity (SI), without effects on insulin secretion.
Treatment-related effects on glucose effectiveness (SG) will be explored.
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Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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