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Off-Label Use of Atypical Antipsychotics: An Update

Slide: 38 of 47

Adverse Effects in Adult Patients: Placebo Comparisons (1 of 2)

The number of patients to be treated in order to observe an adverse effect attributable to the intervention is low for olanzapine, being one in every three patients. In contrast, 1 of 35 patients treated with aripiprazole show the adverse effect. The strength of evidence for this finding is high.

Endocrine and other lab test abnormalities are not as frequently examined or detected as is weight gain, although statistically significant increases when compared with placebo control groups are measurable.

A meta-analysis of 4 studies with a total of 1,387 participants treated with aripiprazole found that 1 of 35 treated patients experienced weight gain or appetite increase attributed to the drug treatment. In 11 studies with a total of 1,637 participants treated with olanzapine, 1 of 3 treated patients experienced weight gain or appetite increase attributed to the drug treatment. In 13 studies with a total of 4,733 participants treated with quetiapine, 1 of 16 treated patients experienced weight gain or appetite increase attributed to the drug treatment. In 4 studies with a total of 434 participants treated with risperidone, 1 of 21 treated patients experienced weight gain or appetite increase attributed to the drug treatment. The strength of evidence for these findings is high. No reports of the effects of ziprasidone on weight or appetite were presented.

For the effects of atypical antipsychotics on endocrine and other metabolic lab tests, no reports of the effect of aripiprazole were presented. A meta-analysis of 2 studies with a total of 374 participants treated with olanzapine found that 1 of 12 treated patients demonstrated endocrine or other metabolic abnormalities attributable to treatment with the drug. A meta-analysis of 3 studies with a total of 1,440 participants treated with quetiapine found that 1 of 18 treated patients demonstrated endocrine or other metabolic abnormalities attributable to treatment with the drug. The strength of evidence for these findings is low. No reports for risperidone or ziprasidone were presented.