Published: 2017-05-23

Study to compare the blood sugar profile of the patients on risperidone and olanzapine with divalproex sodium as the common base

Manjuprasad M. S., Vijayalaxmi M. K., Shreya Hegde, Kamal Sundar T.


Background: Bipolar Affective Disorder which previously was called as manic depressive disorder represents the sixth leading cause of disability. Several preliminary studies suggest that antipsychotic monotherapy or in combination with mood stabiliser have a better prognosis. This study was conducted to compare the blood sugar profile of the patients who are on risperidone and olanzapine with divalproex sodium as the common base.

Methods: It was a prospective, comparative, observational, hospital-based clinical study conducted between November 2013 to March 2015. 41 BPAD patients on Risperidone and 38 BPAD patients on Olanzapine were included. A brief history and examination were carried out and the data was entered in a proforma sheet. The investigations carried out were noted. Patients were followed up for a period of 12 weeks i.e. 2,4,8 and 12th = week and the data analysed using SPSS software. Adverse drug events if any were recorded.

Results: Our study included 79 treatment-naive patients among whom 17 (21.5%) were women and 62 (78.5%) were men. The polarity of the disease of the majority of the patients was mania at the time of diagnosis. The mean blood sugar levels in risperidone and olanzapine group at the time of diagnosis were 137mg% and 111mg% respectively and weights 62kg and 63.5kg respectively. There was a gradual increase in blood sugar levels and weight from 4th week. At the end of the 12th week, the mean blood sugar levels were 152mg% and 164mg%, weights 65.5kg and 69.5kg in risperidone and olanzapine group respectively.

Conclusions: Olanzapine was found to have higher incidence and rapid increase in blood sugar levels which can easily be treated by switching over to another drug. It has been suggested that at least a baseline survey should be undertaken on the prevalence of diabetes in Indian population among patients exposed to antipsychotic drugs.


Bipolar affective disorder, Hyperglycaemia, Olanzapine, Risperidone

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Barekatain M, Khodadadi R, Maracy MR. The outcome of the single manic episode in bipolar I disorder a six-month follow-up after hospitalisation. J Res Med Sci. 2011 Jan;16(1):56-62. PubMed: 21448384.

Swartz HA, Swanson J. Psychotherapy for Bipolar Disorder in Adults: A Review of the Evidence. Focus (Am Psychiatr Publ). 2014;12(3):251-66. PubMed: 2627964.1

Jeong JH, Lee JG, Kim MD, Sohn I, Shim SH, Wang HR, et al. Korean Medication Algorithm for Bipolar Disorder 2014: comparisons with other treatment guidelines. Neuropsychiatr Dis Treat. 2015 Jun;11:1561-71.

Proietto J. Diabetes and Antipsychotic Drugs. Medsafe. 2004 [cited 2016 Dec 27]. Available from:

Lindenmayer JP, Nathan AM, Smith RC. Hyperglycemia associated with the use of atypical antipsychotics. J Clin Psychiatry. 2001;62(23):30-8.

Benson V, Marano MA. Current estimates from the National Health Interview Survey [article online], 1995. Available from

Kawa I, Carter JD, Joyce PR, Doughty CJ, Frampton CM, Wells JE, et al. Gender differences in bipolar disorder: age of onset, course, comorbidity, and symptom presentation. Bipolar Disord. 2005 May 7(2):119-25.

WHO | Gender and women’s mental health. WHO. World Health Organization; 2013. Available from:

Lindenmayer JP, Czobor P, Volavka J, Citrome L, Sheitman B, McEvoy JP, et al. Changes in glucose and cholesterol levels in patients with schizophrenia treated with typical or atypical antipsychotics. Am J Psychiatry. 2003 Feb;160(2):290-6.

Lieberman JA. Metabolic Changes Associated with Antipsychotic Use. Primary Care Companion to The Journal of Clinical Psychiatry. 2004;6(2):8-13.

Smith RC, Lindenmayer JP, Davis JM, Kelly E, Viviano TF, Cornwell J, et al. Effects of olanzapine and risperidone on glucose metabolism and insulin sensitivity in chronic schizophrenic patients with long-term antipsychotic treatment: a randomised 5-month study. J Clin Psychiatry. 2009 Nov;70(11):1501-13.