目 的
第二代抗精神分裂症藥物,近年來已被作為精神分裂症的第一線治療用藥。但愈來愈多的報告顯示,服用這些藥物容易導致體重增加,引發代謝上的異常如:血中三酸甘油酯增加及血糖上升。使用這些第二代抗精神分裂症用藥,評估治療成效之餘,對於代謝方面所產生的副作用,為本研究之主要目的。
方 法
研究對象為台南市立醫院精神科使用 risperidone 與 olanzapine 之門診患者。納入標準:長期服用 olanzapine 或 risperidone 大於 6 個月以上者。排除標準:服藥初期病患即有糖尿病、高血脂症,合併服用其他影響血糖或血脂肪的藥物之患者。本研究採病歷回顧方式,記錄與分析患者服用 olanzapine 或 risperidone 期間,比較與評估下列參數的變化:性別、年齡、疾病的發生及追蹤時間、體重、空腹血糖、膽固醇、三酸甘油酯。
結 果
在 34 個使用 risperidone 的病患中明顯增加空腹血糖值(15.5%)、膽固醇(14.9%)及三酸甘油酯(53.8%),而 olanzapine(32 人)只統計上有意義的增加三酸甘油酯(45.2%)。上述的平均空腹血糖、膽固醇及三酸甘油酯的數值,皆在正常值範圍內。
結 論
依據本研究,第二代抗精神病藥 olanzapine、risperidone 會增加代謝性副作用的危險,且 risperidone 比 olanzapine 易發生。

Objectives 
The second-generation antipsychotics offer a profile of superior safety compared with older, conventional antipsychotic agents in terms of extrapyramidal symptoms. However, the newer agents have been associated with metabolic side effects including hyperglycemia, body weight gain, diabetes mellitus, and abnormal blood lipids. Abnormalities in peripheral glucose regulation and type diabetes mellitus can occur more commonly in schizophrenic patients. We conducted a retrospective clinical study to evaluate the adverse metabolic effects of olanzapine and risperidone. 
Methods 
Patients who were diagnosed with schizophrenia and had taken olanzapine or risperidone for more than 6 months were included. We excluded those who took other drugs known to affect glucose metabolism (including α, β adrenergic blockers, thiazide diuretics, corticosteriods, phenytoin, and volproate), and those who were diagnosed with diabetes mellitus and hyperlipidemia at the initial time of study. We reviewed and analyzed the changes of blood lipids and fasting blood glucose levels noted in the medical records.  
Results 
The results of this study revealed that risperidone had the potential to raise fasting blood glucose (15.5%), cholesterol (14.9%), and triglyceride levels (53.8%), and olanzapine only significantly affected triglyceride (45.2%) metabolism during the medication period. However, all mean blood lipids and fasting blood glucose levels remained within normal clinical range.
Conclusion 
The second-generation antipsychotics can cause adverse metabolic effects; risperidone may have a greater risk compared with olanzapine.