Impact of a switch from typical to atypical antipsychotic drugs on quality of life and gonadal hormones in male patients with schizophrenia.

OBJECTIVES: We investigated the effects of a switch from typical to atypical antipsychotic drugs (olanzapine, n=8; perospirone, n=9; or quetiapine, n=13) on quality of life and hypothalamo-pituitary-gonadal axis hormones.

METHODS: The subjects were 30 male chronic schizophrenia inpatients. The assessment was done before and after the switch.

RESULTS: After the switch, (i) scores of the Brief Psychiatric Rating Scale total and three factors (anxiety-depression, anergia, and thought disturbance) decreased, (ii) the overall severity score of the Drug Induced Extra-Pyramidal Symptoms Scale tended to decrease, (iii) prolactin decreased but gonadal hormones remained unchanged, and (iv) scores on all three subscales (psychosocial, motivation/energy, and symptoms/side effects) in the Japanese version of the Schizophrenia Quality of Life Scale (JSQLS) decreased. However, there were no significant group effects, or time-by-group interactions. In addition, score changes from baseline in psychosocial and motivation/energy subscales in the JSQLS were correlated with those in psychotic symptoms, particularly in the anxiety-depression factor. Moreover, responders had been taking lower doses of typical antipsychotic drugs, and had higher serum estradiol concentrations than non-responders before the switch.

CONCLUSIONS: The study indicated that the switch to atypical antipsychotic drugs was effective in reducing elevated prolactin without affecting the gonadal hormones and in improving quality of life patients who had been treated with typical antipsychotic drugs.