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  • BDD Moderators: Keif’ Richards

The most healthy choice when it comes to antipsychotics

A

Anon54

Ex-Bluelighter
Joined
Jun 11, 2010
Messages
861
I was on zyprexa & Ive changed to seroquel because ive seen a few websites saying it puts on less weight leading to less chance of diabetes i suppose which is a worry for me if im going to keep taking APs.
The study didnt take into consideration the doses so it really cant come up with a definite answer.

I was taking 5mg zyprexa. Now im taking 300mg seroquel.

firstly does anyone have a source to equivalent AP doses?
does anyone know any sources of info about which AP has a greater risk of giving u diabetes?

what would be perfect would be a table listing the APs & a list of different doses of each along with the increased chance of diabetes of weight gain.

Zyprexa & Seroquel feel the same to me so I dont care which I take. I just want the healthier med.
theres other APs too ofcourse which Id like to know about if they put on less weight.

I put on atleast 5kg since starting zyprexa. imagine how fat i'll be after taking it a few years.

maybe i need to talk to a specialist but if any BLers have any info. it would be appreciated.
 
"Healthy" can mean many different things.. With antipsychotics, you are never going to entirely eliminate the risk of adverse effects. It is all about weighing up the risks abd benefits, and sometimes a little trial and error to find the right drug/dosage. This is definitely something to discuss with your psychiatrist..

As I am sure you know, the older "typical" antipsychotics carry a risk of movement disorders termed extrapyramidal side effects (EPSEs) - akathisia (uncomfortable restlessness), tardive dyskinesia (involuntary muscle spasms/tics, often facial), parkinsonism etc - where as with the newer "atypical" drugs the main concern is diabetes and cardiovascular risk (although EPSEs can still occur.) Quetiapine and olanzapine are both atypical antipsychotics.

There is a pretty robust cohort study (link to full text) which followed over 15,000 people newly started on antipsychotics - risperidone, olanzapine and quetiapine - which looked at the risk of diabetes for each. It found that there was no significant difference between the three drugs. The hazard ratio was 1.67 for quetiapine and 1.64 for olanzapine, which means that the study found people taking those antipsychotics were 1.67 or 1.64 times more likely to develop diabetes than the control group. This study is particularly good because of the large sample size, and they have made a pretty decent attempt to eliminate bias/confounding factors. Other smaller studies have found more variable results.

Essentially, it seems that there is no real difference in risk, but people can vary so if you feel you get on better with quetiapine then stick to that, but maybe discuss it with your doctor. Measures such as eating healthily, exercising, not smoking etc will all help.
 
This can vary from person to person and as effie mentioned, "healthy" can mean different things to different people. For me personally, I have found aripiprazole (Abilify) very tolerable in terms of side effects and it does not play around with your glucose levels the way olanzapine (Zyprexa) or risperidone (Risperdal) do. This means less chance of hyperglycemia and less chance of developing diabetes in the long run.
 
^ You're not going to get a definitive answer. As I said, studies show varying results; the one I posted was the highest quality study I found, so that is the one I am more inclinced to go with, but studies can never perfectly replicate life and individual biology can vary. You can look up statistics and figures but that is not going to tell you which drug is more likely to give you diabetes, only what the results were in that particular study population.

In my opinion, from the reading I have done, there is very little in it and the most important thing is to minimise other risk factors (keep your weight down, exercise, don't smoke, good diet etc) but that is just my opinion. All any of us can do here is give you our opinions; perhaps your psychiatrist would be more qualified to answer this than posters on a drugs forum?
 
From a strictly observational standpoint, I see Zyprexa as encouraging more weight gain than Seroquel, even though Seroquel can certainly cause it, too. Zyprexa has a long half-life, so even if you take it at bedtime, it will be in your system 24 hours a day. Seroquel has a shorter half-life, and while it will still be in your system 24 hours a day, the effect won't be as pronounced throughout the day as it is at night, but 300 mg is a lot.
 
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