Abstract:

AIM: To explore the effect of paliperidone and olanzapine treating patients with first-episode schizophrenia and their influence on sugar metabolism and serum levels of brain-derived neurotrophic factor (BDNF).  METHODS: 80 patients with first-episode schizophrenia were randomly divided into paliperidone group (n=40) and olanzapine group (n=40) for an 8-week study. Positive and Negative Syndrome Scale (PANSS) was used to assess clinical efficacy, at the same time the Treatment Emergent Symptom Scale (TESS) was used to assess treatment of adverse reactions. Fasting blood sugar of the two groups  at baseline, 4th and 8th weekend were detected, and serum levels of BDNF were measured by enzyme-linked immuno sorbent assay (ELISA). RESULTS:The effective rate was similar (68.4% vs.63.1%, P>0.05 ) after 8 weeks of treatment; In both groups, the factors and total scores of PANSS at the 4th, 8th weekend were significantly lower than those at the baseline, the difference was statistically significant (P<0.05), yet positive and negative symptoms score had no statistical significant differences between two groups. Comparison between the groups, olanzapine group FBS levels at 8th weekend had increased significantly than the 4th weekend (P<0.01), and paliperidone group had no significant differences. Comparison between groups, FBS levels in olanzapine group were obviously higher than those of paliperidone groups at the 8th weekend, the difference was statistically significant (P<0.01). BDNF concentrations of two groups were significantly higher at 4th, 8th weekend than those at the baseline (P<0.01). Comparison between groups, BDNF concentration in paliperidone group was obviously higher than that of olanzapine groups at the 8th weekend, the difference was statistically significant (P<0.01). CONCLUSION: Paliperidone and olanzapine have similar clinical efficacy in treating first-episode schizophrenia, paliperidone is better than olanzapine in regulating sugar metabolism index and elevated serum concentration of BDNF.

Key words: schizophrenia, paliperidone, olanzapine, sugar metabolism, brain-derived neurotrophic factor