Effects of Adjunctive Betahistine Therapy on Lipid Metabolism in Patients with Chronic Schizophrenia: A Randomized Double-Blind Placebo-Controlled Study

Luyuan Bai,1 Weiye Liang,1 Yongqian Wang,2 Ning Fan,1 Qi zhang,3 Yun Bian,1 Fude Yang1 1Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, People’s Republic of China; 2Office of Scientific Research, Peking University Health Science Center, Beijing, People’s Republic of China; 3Department of Psychology, Wuxi Mental Health Center, Wuxi, People’s Republic of ChinaCorrespondence: Fude Yang; Yun Bian, Peking University Huilongguan Clinical Medical School, 7, Nandian Road, Huilongguan, Changping District, Beijing, 100096, People’s Republic of China, Tel +86-010-83024456 ; +86-010-83024572, Email yangfd_200@163.com; ihqihqajjq@163.comObjective: This study aims to explore the ability of betahistine to inhibit weight gain and abnormal lipid metabolism in patients with chronic schizophrenia.Methods: A comparison study of betahistine or placebo therapy was conducted for 4 weeks in 94 patients with chronic schizophrenia, who were randomly divided into two groups. Clinical information and lipid metabolic parameters were collected. Positive and Negative Syndrome Scale (PANSS) was used to assess psychiatric symptoms. Treatment Emergent Symptom Scale (TESS) was used to evaluate treatment-related adverse reactions. The differences in lipid metabolic parameters before and after treatment between the two groups were compared.Results: Repeated measures analysis of variance (ANOVA) revealed that after 4 weeks of betahistine/placebo treatment, the interaction effect of time and group was statistically significant on low-density lipoprotein cholesterol (F = 6.453, p = 0.013) and waist-to-hip ratio (F = 4.473, p = 0.037), but did not reveal any significant interaction effect of time and group on weight, body mass index or other lipid metabolic parameters, as well as the time main effect and group main effect (all p > 0.05). Betahistine had no significant impact on PANSS, and no side effects related to betahistine were detected.Conclusion: Betahistine may delay metabolic abnormalities in patients with chronic schizophrenia. It does not affect the efficacy of the original antipsychotics. Thus, it provides new ideas for the treatment of metabolic syndrome in patients with chronic schizophrenia.Keywords: schizophrenia, lipid metabolism, betahistine, histamine, H3-receptor antagonist