The author is a member of the advisory boards of Eli-Lilly and Bristol-Myers Squibb, and his congress fees are paid for by Astra-Zeneca.
Effect of risperidone on ghrelin and glucose in schizophrenia
Article first published online: 14 SEP 2007
Psychiatry and Clinical Neurosciences
Volume 61, Issue 5, page 576, October 2007
How to Cite
COHEN, D. (2007), Effect of risperidone on ghrelin and glucose in schizophrenia. Psychiatry and Clinical Neurosciences, 61: 576. doi: 10.1111/j.1440-1819.2007.01712.x
- Issue published online: 14 SEP 2007
- Article first published online: 14 SEP 2007
- Received 21 February 2007; revised 10 May 2007; accepted 16 May 2007.
The cross-sectional study of 15 risperidone-treated patients with schizophrenia showed increased ghrelin levels compared with healthy controls.1 The study raises several questions. First, the interpretation is hampered by the contradicting results of studies in this field. Some studies showed decreased ghrelin during risperidone and olanzapine treatment,2 other studies showed increased ghrelin during clozapine, olanzapine, risperidone and quetiapine therapy.3 In two olanzapine studies, treatment resulted in increased4 or decreased ghrelin levels.5 In short: larger, preferably prospective studies are needed to decide whether risperidone (or any atypical) effects ghrelin levels and, if so, what the effect is: increase or decrease.
Second, the diabetogenic effect of risperidone – only three cases – is severely underestimated by the authors. A survey, published in 2003, reported 78 cases of new-onset diabetes mellitus.6 Together with two recently published case reports7,8 this adds up to a total of 80 cases.
Third, comparison of antipsychotic-treated schizophrenia patients with healthy controls bypasses the distinction between a drug-induced and a disease-inherent effect.9 The study design in the Murashita et al.1 study does not allow for this distinction, which means that further studies of both untreated, drug-naïve patients as well as antipsychotic-treated patients are needed to clarify this issue.
- 9Diabetes Mellitus in Schizophrenia or Schizoaffective Disorder: An Endogenic or Iatrogenic Problem? Thesis, Haarlem, 2007..