Adiposity and Insulin Sensitivity Derived from Intravenous Glucose Tolerance Tests in Antipsychotic-Treated Patients

Effects of Olanzapine and Ziprasidone on Glucose Tolerance in Healthy Volunteers

“…These data indicate a significant decrease in whole body insulin sensitivity after oral intake of olanzapine, 10 mg/day for 10 days, after 80 min (po0.015), 100 min (po0.001), and 120 min (po0.0001) of glucose clamp. Effects of olanzapine and ziprasidone J Sacher et al population but is not associated with the risk of DM2 during antipsychotic treatment does not seem very likely given the evidence for a higher rather than a lower prevalence of DM2 in patients suffering from a major mental disorder in almost all data sets published to date (Mukherjee et al, 1996;Dixon et al, 2000;Okamura et al, 2000;Mokdad et al, 2001;Haupt and Newcomer, 2002;Newcomer et al, 2002;Ryan et al, 2003;Newcomer, 2004;Haupt et al, 2007). A second metabolic effect is depicted in Figure 2 and Table 2.…”

“…Up to date, several studies investigating olanzapineinduced changes in glucose metabolism in patients have been published (Hedenmalm et al, 2002;Koller and Doraiswamy, 2002;Sernyak et al, 2002;Wilson et al, 2003;Simpson et al, 2004;Haupt et al, 2007). Newcomer et al (2002) tested oral glucose tolerance in chronically ill BMImatched patients with schizophrenia.…”

“…The well-established adiposity-mediated mechanism plays a central role in atypical antipsychotic-induced insulin resistance (American Diabetes Association, 2004b;Casey et al, 2004;Newcomer, 2005;Haupt, 2006;Haupt et al, 2007). Besides unhealthy eating habits of patients with schizophrenia, treatment with atypical antipsychotics seems to increase appetite and worsen opiodergic capacity, thus further deteriorating eating patterns (Elman et al, 2006).…”

“…Despite the welldescribed effects of adiposity on glucose metabolism in the general population (Welch et al, 1990;Karter et al, 1996;Macor et al, 1997;Mayer-Davis et al, 1997), the underlying mechanisms for potential adiposity-independent effects of atypical antipsychotics on insulin sensitivity have not been identified yet. While most studies report an increased risk for the development of metabolic abnormalities like glucose intolerance, insulin-resistance, and consequentially DM2 in rodent (Houseknecht et al, 2005) or dog studies as well as in patients with schizophrenia (Hedenmalm et al, 2002;Koller and Doraiswamy, 2002;Newcomer et al, 2002;Sernyak et al, 2002;Wilson et al, 2003;Kane et al, 2004;Simpson et al, 2004;Henderson et al, 2005, 2006, Haupt et al, 2007, patients with schizoaffective disorder (Wilson et al, 2003;Simpson et al, 2004) or patients with mood disorder (Gianfrancesco et al, 2003) treated with atypical antipsychotics, other studies fail to confirm these correlations for healthy subjects (Sowell et al, 2002(Sowell et al, , 2003 or patients with schizophrenia (Kinon et al, 2001).…”

Getting to More Effective Weight Management in Antipsychotic-Treated Youth: A Survey of Barriers and Preferences

“…2 Higher rates of obesity in this population are, in part, attributable to antipsychotic treatment, which has well-established effects on adiposity and glucose regulation. 3 Thus, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) has identified individuals with mental illness, including those treated with antipsychotic medications, as a ''special population'' at increased risk for the development of obesity, diabetes, and CVD. 4 The prevalence of type 2 diabetes (T2D) among youth in the general population is 0.46 per 1000 youth, 5 with the majority of new-onset cases explained by high weight.…”