That was the time when, four years after introduction of the first antipsychotic chlorpromazine in therapy, data were published on the occurrence selleck of hyperglycemia and glucosuria in previously euglycemic patients who were administered chlorpromazine. There were also concurrent descriptions of cases of impaired glycemic control in diabetics on chlorpromazine therapy. Upon discontinued administration of chlorpromazine, normalization of glycemia was achieved as well as diabetes control at the levels prior to antipsychotic therapy.8 Metabolic side-effects have, however, been shown to accompany not only the administration of conventional antipsychotics
like chlorpromazine. Actually, similar problems have been reported during introduction of the novel, so-called atypical antipsychotics. Introduction of atypical antipsychotics in therapy has significantly promoted the treatment of patients affected by schizophrenia Obeticholic Acid manufacturer and other psychotic disorders. Compared to conventional antipsychotics, the major advantage of these drugs is lower frequency of extrapyramidal side-effects and of hyperprolactinemia, and better overall tolerance. Still, some of atypical antipsychotics have been associated
with body weight gain, occurrence of diabetes, and increase in cholesterol and triglyceride levels.8 Olanzapine, a thienobenzodiazepine derivative, is a second generation (atypical) antipsychotic agent, which has proven efficacy against the positive and negative symptoms of schizophrenia. Compared with conventional antipsychotics, it has greater affinity for serotonin 5-HT2A Rutecarpine than for dopamine D2 receptors. In large, well controlled trials in patients with schizophrenia or related psychoses, olanzapine 5–20 mg/day was significantly superior to haloperidol 5–20 mg/day in overall improvements in psychopathology rating scales and in the treatment of depressive and negative symptoms, and was comparable in effects on positive psychotic symptoms. The 1-year risk of relapse (rehospitalisation) was significantly
lower with olanzapine than with haloperidol treatment. Olanzapine is associated with significantly fewer extrapyramidal symptoms than haloperidol and risperidone. In addition, olanzapine is not associated with a risk of agranulocytosis as seen with clozapine or clinically significant hyperprolactinaemia as seen with risperidone or prolongation of the QT interval. The most common adverse effects reported with olanzapine are body weight gain, somnolence, dizziness, anticholinergic effects (constipation and dry mouth) and transient asymptomatic liver enzyme elevations.9 Chlorpromazine is one of a group of antipsychotic drugs known as typical agents. It is originally tested as an antihistamine and then proposed as a drug for combating helminth infections, later it was emerged as an effective treatment for psychotic illness in the 1950s.