In three identically designed open-label studies, patients who switched from olanzapine or risperidone to Geodon (ziprasidone HCl) showed substantial weight loss, as well as improvements in cholesterol and triglycerides that continued for the duration of the year-long studies, according to findings presented here at the American Psychiatric Association (APA) meeting.

A total of 270 patients with schizophrenia were switched to Geodon from olanzapine, risperidone or conventional antipsychotics. Patients who completed 6 weeks of treatment, and were clinically stable, were then eligible for an additional 52 weeks extension study, where Geodon treatment was continued.

"The results of these studies suggest that switching to Geodon can help to reverse the adverse effects on weight and lipids seen with these agents," noted lead investigator, Peter J. Weiden, MD, professor of psychiatry, SUNY Downstate Medical Center in Brooklyn. "Weight loss was progressive and persistent, while the lipid changes seen early in the study were sustained throughout the one-year study period."

The amount of weight loss was related to the amount of time patients had been discontinued from olanzapine or risperidone. Results of the analysis showed that average weight loss at one year was 22 lbs in patients switched from olanzapine, and 15 lbs in patients switched from risperidone.

"A reduction in weight and lipids of the magnitude observed in these studies may be associated with significantly reduced cardiovascular and metabolic-related events such as heart disease and diabetes," said Harold E. Lebovitz, professor of medicine, Division of Endocrinology and Metabolism/Diabetes, SUNY, Downstate Medical Center in Brooklyn.

These findings come at a time when there is growing concern around the link between second generation antipsychotics (SGAs) and increased risks for obesity, diabetes, and lipid abnormalities. A recent consensus statement issued by a panel of experts, including representatives of the American Diabetes Association (ADA) and the American Psychiatric Association (APA), found that SGAs differ in their risks for weight gain and diabetes. While the consensus statement noted that Geodon had less long-term data , it stated that Geodon was associated with little or no significant weight gain, and carries a lower risk of diabetes, or dyslipidemia compared with some other SGAs.1

In addition to weight changes, significant reductions in cholesterol and triglycerides were seen in patients switched to Geodon. These benefits occurred within the first 6 weeks after the switch2, and were then sustained for the next year. For example, results of the analysis showed an average -18 mg/dL cholesterol reduction, and a -55 mg/dL triglyceride reduction in patients switched to Geodon from olanzapine at one year. A similar pattern, but lower magnitude of lipid benefits, were seen among patients switched from risperidone at one year.