Some atypical antipsychotics particularly clozapine and olanzapine have serious metabolic side effects like metabolic syndrome.

To determine whether olanzapine-induced metabolic abnormalities identified through monitoring can be changed by switching to aripiprazole in patients with schizophrenia.

Current research show that fifty stable outpatients suffering from metabolic side effects due to olanzapine medication were switched to an open-label, flexible-dose of aripiprazole (10-30 mg/day) in this 13-week naturalistic study. An extensive metabolic evaluation was conducted on all patients, at baseline, at 6 weeks, and at 13 weeks post switch. Metabolic abnormalities consist of new onset diabetes, impaired fasting glucose, impaired glucose tolerance, metabolic syndrome according to various definitions, and dyslipidemia. After 13 weeks of treatment with aripiprazole (mean dosage 16.8 mg / day), there was a significant decrease in body weight, body mass index, and waist circumference. The rates of in fasting glucose, fasting insulin, insulin resistance index, and serum lipids levels (cholesterol, triglycerides, low-density lipoprotein (LDL), LDL/HDL, Chol/HDL, and non-HDL cholesterol) were reduced. Also three subjects with recent onset diabetes were reversed at 3 months follow-up. The metabolic syndrome was reversed in 64% of patients at 3 months.

The change of psychotropic drug treatment from olanzapine to aripiprazole in stable outpatients with schizophrenia was generally well tolerated and was associated with significant improvements at 13 weeks. Results support the reversibility of olanzapine-induced metabolic abnormalities when detected early and followed by a switch to aripiprazole.