Comparative Assessment of the Metabolic Impact of Risperidone and Trifluoperazine in Drug-Naïve Psychotic Patients: A Prospective Observational Study

Abstract

Background: Patients with schizophrenia face a 20% lower life expectancy than the general population, primarily due to cardiovascular complications linked to antipsychotic-induced metabolic syndrome.
Materials and Methods: This prospective, observational, non- randomised study compared the metabolic effects of risperidone (n=38) and trifluoperazine (n=38) in 76 drug-naïve patients over 12 weeks. Parameters included BMI, waist circumference, blood pressure, HbA1c, and lipid profiles.
Results: Significant baseline imbalances were noted, with the risperidone group exhibiting higher weight (p = 0.002) and BMI (p = 0.002). Post-treatment, risperidone induced a markedly higher metabolic burden, particularly in HbA1c (22.82% increase) and triglycerides (32.79% increase) compared to trifluoperazine.
Conclusion: Second-generation antipsychotics like risperidone carry a significantly higher metabolic liability than first-generation agents, necessitating early and vigilant metabolic monitoring.