Antipsychotic Medication May Affect HDL-Cholesterol Levels for Some Patients With Schizophrenia

These results may be helpful for clinicians when considering the effects of antipsychotic intervention on patient high-density lipoprotein cholesterol levels.

High-density lipoprotein (HDL)-cholesterol levels in overweight patients with schizophrenia may be influenced by antipsychotic medication type, according to study data published in BMC Psychiatry.

Researchers conducted a post hoc analysis of respondents to a Japanese national survey. The survey included 433 outpatients and 674 inpatients with schizophrenia. A brief questionnaire captured sociodemographic characteristics, systolic and diastolic blood pressure, and HDL-cholesterol for each participant. HDL-cholesterol levels were compared between patients receiving olanzapine, aripiprazole, and risperidone and stratified by body mass index (BMI). Participants had a mean age of 57.9 ± 14.0 years and an average BMI of 23.4 ± 4.5 kg/m2.

After adjusting for age, diastolic blood pressure, antipsychotic dosage, and waist circumference and stratifying by BMI, HDL-cholesterol levels among inpatients differed significantly between the 3 antipsychotic groups (P =.019). Among overweight inpatients specifically, HDL-cholesterol was significantly lower in the olanzapine group than in the aripiprazole group (P =.023). However, among underweight inpatients or inpatients of normal weight, HDL-cholesterol levels did not differ by antipsychotic type. In addition, no significant differences between antipsychotics were observed in HDL-cholesterol levels for outpatients of any BMI stratification.

These data highlight a correlation between HDL-cholesterol levels and the use of certain antipsychotic among overweight inpatients with schizophrenia. Although further studies are needed to elucidate the precise mechanisms of this effect, these results may be helpful for clinicians in considering the potential effect antipsychotic intervention may have on patient HDL-cholesterol levels.

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Funding: This work was partially supported by Eisai Co. Ltd., Yoshitomi Pharmaceutical Industries, Dainippon Sumitomo Pharma Co. Ltd., Astellas Pharma Inc., Meiji Seika Pharma Co. Ltd., Eli Lilly Japan K.K., Otsuka Pharmaceutical Co. Ltd., GlaxoSmithKline K.K., Janssen Pharmaceutical K.K., MSD K.K., Shionogi & Co. Ltd., Asahi Kasei Pharma Corp., Novartis Pharma Co. Ltd., Takeda Pharmaceutical Co. Ltd., Ono Pharmaceutical Co. Ltd., and Tsumura & Co. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Disclosures: Please see study online for a full list of disclosures.


Ono S, Sugai T, Suzuki Y, et al. High-density lipoprotein-cholesterol and antipsychotic medication in overweight inpatients with schizophrenia: post-hoc analysis of a Japanese nationwide survey. BMC Psychiatry. 2018;18:180.