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| Effect of different doses of Topiramate combined with Olanzapine in the treatment of schizophrenia and its influence on body mass index and glucose and lipid metabolism |
| LI Liang1 DAI Xiongkai1 WANG Tiehu1 ZENG Lei2 WU Jinjin3 LI Jianhua4 |
1.Department of Psychiatry, Huzhou Third People’s Hospital, Zhejiang Province, Huzhou 313000, China;
2.Department of Psychosomatics, Huzhou Third People’s Hospital, Zhejiang Province, Huzhou 313000, China;
3.Department of Emergency, Huzhou Third People’s Hospital, Zhejiang Province, Huzhou 313000, China;
4.Department of Forensic Expertise, Huzhou Third People’s Hospital, Zhejiang Province, Huzhou 313000, China
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Abstract Objective To explore the effect of different doses of Topiramate combined with Olanzapine in the treatment of schizophrenia and its effect on body mass index (BMI) and glucose and lipid metabolism. Methods A total of 120 patients with schizophrenia who underwent outpatient and inpatient treatment in the Department of Psychiatry, the Huzhou Third People’s Hospital from November 2020 to February 2022 were selected and they were divided into control group, experimental group 1, and experimental group 2 according to the random number table method, with 40 patients in each group. The control group was treated with Olanzapine, the experimental group 1 was treated with Topiramate (maximum dose of 100 mg) + Olanzapine, and the experimental group 2 was treated with Topiramate (maximum dose of 200 mg) + Olanzapine for 12 weeks. The scores of positive and negative syndrome scale (PANSS), BMI, and glucose and lipid metabolism indexes (fasting blood glucose [FBG], fasting insulin [FINS], triglyceride [TG], low-density lipoprotein cholesterol [LDL-C], total cholesterol [TC] levels, and safety were compared among the three groups. Results Before treatment, there was no significant difference in PANSS scores among the three groups (P＞0.05). Comparison between experiment group 1 and control group: there was no significant difference in PANSS score between experimental group 1 and control group at 4 weeks (P＞0.05), the PANSS score of experiment group 1 was lower than that of control group after 8 and 12 weeks of treatment, and the differences were statistically significant (P＜0.05). Comparison between experimental group 2 and control group: after 4, 8 and 12 weeks of treatment, PANSS score of experimental group 2 was lower than those of control group, and the differences were statistically significant (P＜0.05). Comparison between experiment group 1 and experiment group 2: the PANSS score of experiment group 2 were lower than that of experiment group 1 after 4, 8 and 12 weeks of treatment, and the differences were statistically significant (P＜0.05). Intra-group comparison among the three groups: compared with before treatment, PANSS scores in the three groups decreased after 4, 8 and 12 weeks of treatment, and the differences were statistically significant (P＜0.05). After treatment, the levels of BMI, FBG, FINS, TG, LDL-C, and TC in experimental group 1 and experimental group 2 were lower than those in control group (P＜0.05), but there was no statistical significance between experimental group 1 and experimental group 2 (P＞0.05). There was no significant difference in the total incidence of adverse reactions among the three groups (P＞0.05). There was significant difference in the incidence of paresthesia among the three groups (P＜0.05). Conclusion The treatment of Topiramate in patients with schizophrenia can improve the body weight increase caused by olanzapine, regulate the metabolism of glucose and lipids, and relieve mental symptoms; the 200 mg dose of topiramate has a more obvious improvement effect, but it can increase the incidence of paresthesias.
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