Assessment of the metabolic effects of Risperidone and Trifluoperazine in drug-naïve psychotic patients attending the psychiatry outpatient department of a tertiary care hospital

Abstract

Background: Schizophrenia is a chronic, disabling psychiatric disorder that imposes a significant burden on affected individuals, families, and healthcare systems. Antipsychotic medications remain the cornerstone of its management. However, long-term use of these medications, particularly second-generation antipsychotics like risperidone and typical agents such as trifluoperazine, is associated with metabolic disturbances, which increase the risk of cardiovascular morbidity and mortality. Hence, evaluating and comparing the metabolic side effect profiles of these drugs is of clinical importance.

Materials and Methods: 

This was a prospective, comparative, observational study conducted at a tertiary care hospital in Madhya Pradesh. A total of 76 patients diagnosed with schizophrenia as per ICD-10 criteria were enrolled and equally distributed into two groups based on the antipsychotic prescribed—risperidone (n=38) and trifluoperazine (n=38). Socio-demographic data, clinical variables, and relevant biochemical parameters were recorded at baseline and repeated at three months

Result : 

At baseline, the risperidone group showed significantly higher mean weight (62.6 kg vs. 52.8 kg, p=0.002), BMI (25.3 vs. 20.2, p=0.002), waist circumference (86.6 cm vs. 78.4 cm, p=0.018), and triglyceride levels (90.2 mg/dL vs. 113.2 mg/dL, p=0.001), compared to the trifluoperazine group. Over the three-month follow-up, patients on risperidone experienced a more marked increase in weight, BMI, waist circumference, blood pressure, fasting glucose, HbA1c, total cholesterol, LDL, and triglyceride levels compared to those on trifluoperazine.

1. Conclusion : In conclusion, this study highlights the greater metabolic liability of risperidone over trifluoperazine, indicating the need for vigilant monitoring of metabolic parameters in patients on atypical antipsychotics.