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Impact of Aripiprazole and Clozapine on Serum Growth Hormone: A Clinical Retrospective Study
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| Author:
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ROBERTO LOZANO, CARINA BONA
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| Abstract:
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Background: Growth hormone (GH) plays a critical role in metabolic regulation, body composition, and neuroendocrine function. Antipsychotic treatments, particularly second-generation agents such as aripiprazole and clozapine, have been associated with neuroendocrine disturbances, but their long-term impact on GH levels remains underexplored.
Objective: To assess and compare GH serum concentrations in patients with schizophrenia spectrum or bipolar disorders treated with aripiprazole or clozapine over at least five consecutive years.
Methods: This retrospective observational study included 112 adult patients diagnosed with schizophrenia (F20), schizoaffective disorder (F25), or bipolar disorder (F31), treated at two psychiatric units between 2016 and 2021. GH levels were assessed cross-sectionally (n=78) and in a longitudinal subcohort (n=34) with serial evaluations over 5 years. Anthropometric and biochemical parameters were recorded. Statistical comparisons included t-tests, Chi-square/Fisher's tests, and odds ratios for GH deficiency (GHD), defined as GH <0.4 ng/mL.
Results: Patients on clozapine exhibited significantly lower mean GH levels (0.28 ± 0.25 ng/mL) compared to those on aripiprazole (0.62 ± 0.44 ng/mL; p < 0.01). GHD was detected in 58.3% of clozapine users versus 19.4% in the aripiprazole group (OR = 5.8; 95% CI: 2.0–16.4). In the longitudinal cohort, sustained GH suppression was more prevalent in clozapine-treated patients. GH levels inversely correlated with BMI and prolactin concentrations.
Conclusion: Clozapine is associated with a higher prevalence and persistence of GH suppression compared to aripiprazole. These findings highlight the need for endocrine monitoring in long-term antipsychotic therapy, especially in patients with metabolic risk factors.
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| Keyword:
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Growth hormone, Aripiprazole, Clozapine, Antipsychotics, Schizophrenia, Hormonal suppression, Neuroendocrine effects, GH deficiency.
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2025.17.03.006
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| Download:
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