A double-blind, placebo-controlled trial of rosiglitazone for clozapine-induced glucose metabolism impairment in patients with schizophrenia

Acta Psychiatr Scand. 2009 Jun;119(6):457-65. doi: 10.1111/j.1600-0447.2008.01325.x. Epub 2009 Jan 12.

Abstract

Objective: The primary purpose of this 8-week double-blind, placebo-controlled trial of rosiglitazone 4 mg/day was to examine its effect on insulin sensitivity index (SI) and glucose utilization (SG) in clozapine-treated subjects with schizophrenia with insulin resistance.

Method: Eighteen subjects were randomized and accessed with a Frequently Sampled Intravenous Glucose Tolerance Test (FSIVGTT) at baseline and at week 8 to estimate SG and SI.

Results: Controlling for the baseline, comparing the rosiglitazone group with placebo group, there was a non-significant improvement in SG (0.016 +/- 0.006-0.018 +/- 0.008, effect size = 0.23, P = 0.05) with a trend of improvement in SI in the rosiglitazone group (4.6 +/- 2.8-7.8 +/- 6.7, effect size = 0.18, P = 0.08). There was a significant reduction in small low-density lipoprotein cholesterol (LDL-C) particle number (987 +/- 443-694 +/- 415, effect size = 0.30, P = 0.04).

Conclusion: Rosiglitazone may have a role in addressing insulin resistance and lipid abnormalities associated with clozapine.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Glucose / metabolism
  • Cholesterol, LDL / metabolism
  • Clozapine / adverse effects*
  • Clozapine / therapeutic use
  • Double-Blind Method
  • Female
  • Glucose Tolerance Test
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Insulin Resistance
  • Male
  • Metabolic Syndrome / chemically induced*
  • Metabolic Syndrome / drug therapy
  • Middle Aged
  • Placebos
  • Rosiglitazone
  • Schizophrenia / drug therapy*
  • Schizophrenia / metabolism
  • Thiazolidinediones / therapeutic use*

Substances

  • Blood Glucose
  • Cholesterol, LDL
  • Hypoglycemic Agents
  • Placebos
  • Thiazolidinediones
  • Rosiglitazone
  • Clozapine