الملخص الإنجليزي
Objective: To evaluate the impact of olanzapine, alone or in combination with other
atypical antipsychotics (AAPs), on metabolic changes, in psychotic patients at Sultan Qaboos
University Hospital (SQUH), Muscat, Oman.
Methods: This is a retrospective cohort study, in patients attending psychiatry clinics at
SQUH, Muscat, Oman, between 1st January 2019 and 31st December 2019, and prescribed
olanzapine, alone or in combination with other AAPs. Patients were followed up retrospectively
from the start date till April 2021. The metabolic components included body weight, body mass
index (BMI), total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density
lipoprotein cholesterol (HDL-C), triglycerides, glucose, hemoglobin A1c, (HbA1c), systolic blood
pressure (BP) and diastolic BP. Therapeutic goal attainments were evaluated as per the Task Force
for the Management of Dyslipidaemias of the European Society of Cardiology (ESC) and
European Atherosclerosis Society (EAS) in 2019.
Results: The study enrolled a total of 253 patients (with a mean age of 40±17 years and
69% (n=174) were females) of which 78% (n=197) were on olanzapine alone while 22% (n=56)
were on olanzapine in combination with other AAPs. After excluding patients with diabetes
mellitus, hypertension and dyslipidemia (n=195), AAPs were associated with significant increases
in body weight (+8.6; 95% confidence interval (CI): 7.0-10.2 kg; p<0.001), BMI (+3.4; 95% CI:
2.7-4.0 kg/m2; p<0.001), total cholesterol (+0.4; 95% CI: 0.3-0.5 mmol/L; p<0.001), LDL-C
(+0.3; 95% CI: 0.2-0.4 mmol/L; p<0.001), triglycerides (+0.3; 95% CI: 0.2-0.4 mmol/L; p<0.001),
glucose (+0.4; 95% CI: 0.3-0.6 mmol/L; p<0.001), HbA1c (+0.2; 95% CI: 0.1-0.3%; p<0.001),
systolic BP (+9; 95% CI: 7-11 mmHg; p<0.001) and diastolic BP (+3; 95% CI: 2-5 mmHg;
p<0.001). No changes in HDL-C were observed (p=0.981). Therapeutic goal attainments for the
lipid components were 38% (n=97), 61% (n=154), and 71% (n=180) for LDL-C, non-HDL-C, and
triglycerides levels, respectively. A total of 59% (n=150) of the patients were at their BP goal
while only 28% (n=71) had normal optimum body weight. HbA1c was at goal (<7%) in 96%
(n=236) of the cohort.
Conclusions: Olanzapine was associated with significant increases in metabolic
components. A significant proportion of patients were not at their therapeutic targets.
