Glucose Intolerance with Atypical Antipsychotics

Hedenmalm, Karin; Hägg, Staffan; Ståhl, Malin; Mortimer, Örjan; Spigset, Olav

doi:10.2165/00002018-200225150-00005

Cited by 107 publications

(55 citation statements)

References 34 publications

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“…In general , the possibility to develop diabetes at advanced age depends more on the chronic-degenerative pathologies, frailty, reduced physical activity, malnutrition, infective components, insulin-resistance, adverse drug reactions, rather than on hereditary-familiar factors (Goldberg and Coon, 1994;Hedenmalm et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

Diabetes mellitus in the extreme longevity

Motta

Bennati

Capri

et al. 2008

Experimental Gerontology

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Section: Discussionmentioning

confidence: 99%

Diabetes mellitus in the extreme longevity

Motta

Bennati

Capri

et al. 2008

Experimental Gerontology

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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).…”

Section: Introductionmentioning

confidence: 99%

Effects of Olanzapine and Ziprasidone on Glucose Tolerance in Healthy Volunteers

Sacher

Mossaheb

Spindelegger

et al. 2007

Neuropsychopharmacol

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Atypical antipsychotics have been linked to a higher risk for glucose intolerance, and consequentially the development of type 2 diabetes mellitus (DM2). We have therefore set out to investigate the acute effects of oral administration of olanzapine and ziprasidone on whole body insulin sensitivity in healthy subjects. Using the standardized hyperinsulinemic euglycemic clamp technique we compared whole body insulin sensitivity of 29 healthy male volunteers after oral intake of either olanzapine 10 mg/day (n ¼ 14) or ziprasidone 80 mg/day (n ¼ 15) for 10 days. A significant decrease (po0.001) in whole body insulin sensitivity from 5.7 ml/h/kg ( ¼ mean, SM ¼ 0.4 ml/h/kg) at baseline to 4.7 ml/h/kg ( ¼ mean, SM ¼ 0.3 ml/h/kg) after oral intake of olanzapine (10 mg/day) for 10 days was observed. The ziprasidone (80 mg/day) group did not show any significant difference (5.2 ± 0.3 ml/h/kg baseline vs 5.1 ± 0.3 ml/h/kg) after 10 days of oral intake. Our main finding demonstrates that oral administration of olanzapine but not ziprasidone leads to a decrease in whole body insulin sensitivity in response to a hyperinsulinemic euglycemic challenge. Our finding is suggestive that not all atypical antipsychotics cause acute direct effects on glucose disposal and that accurate determination of side effect profile should be performed when choosing an atypical antipsychotic.

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“…During the 1960s, there was a general acceptance that antipsychotic drugs could cause diabetes and the term "phenothiazine diabetes" was introduced. The issue was largely forgotten, until interest was rekindled with the observation that atypical antipsychotic drugs may be associated with a higher risk of IGT and diabetes as compared to conventional antipsychotics [28][29][30]. Most interestingly, several observations in both humans and animals support the concept that atypical antipsychotics may have profound effects on glucose metabolism, independent of psychiatric disease [5].…”

Section: Antipsychotics and Glucose Disturbancesmentioning

confidence: 99%

Abnormal glucose metabolism in patients treated with antipsychotics

Scheen

Hert

2007

Diabetes & Metabolism

151

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Second-generation (atypical) antipsychotic medications are of great benefit to a wide variety of people with psychiatric disorders, especially patients with schizophrenia. However, one constellation of adverse effects is an increased risk of obesity, diabetes, and metabolic syndrome. Increasing numbers of reports concerning impaired glucose tolerance, diabetes, and ketoacidosis have raised concerns about a possible association between abnormal glucose metabolism and treatment with atypical antipsychotics, although the question is still debated because of the presence of many confounding factors. A close relationship between drug-induced weight gain and risk of diabetes has been reported, emphasizing the role of insulin resistance. However, some cases of diabetes developed independently of weight gain, rather rapidly and possibly progressing to ketoacidosis, thus arguing for a severe impairment of insulin secretion. Another debated question is whether diabetes risk is a class action or a differential action. Although not fully scientifically proven yet, available evidence suggests that clozapine and olanzapine have a higher propensity to induce diabetes and metabolic syndrome compared with other atypical antipsychotic drugs, risperidone and quetiapine. Despite more limited available data, amisulpride, aripiprazole and ziprazidone showed less likelihood of precipitating diabetes. Interestingly, reversibility of drugrelated diabetes has been reported with aripiprazole. The choice of atypical antipsychotic medication for a specific patient depends on many factors, but the likelihood of developing diabetes should become an important consideration. When prescribing an atypical antipsychotic, a commitment to careful baseline screening and follow-up monitoring is essential in order to mitigate the risk of developing diabetes and associated complications.Keywords: antipsychoticsa; schizophrenia ; diabetes ; impaired glucose tolerance ; metabolic syndrome ; review RésuméLes antipsychotiques de seconde génération, appelés aussi antipsychotiques atypiques, ont apporté une aide précieuse dans la prise en charge de nombreux patients psychiatriques, en particulier ceux avec schizophrénie. Cependant, ils semblent associés à une constellation d'effets indésirables métaboliques, avec un risque accru d'obésité, de diabète et de syndrome métabolique. Un nombre croissant de publications à propos de cas de diminution de tolérance au glucose, de diabète et d'acidocétose chez des patients traités avec des antipsychotiques atypiques plaident pour une association causale possible entre une anomalie du métabolisme du glucose et le traitement par antipsychotique atypique, même si la question reste controversée suite à la présence de nombreux facteurs confondants. Une relation étroite entre la prise de poids induite par la médication et le risque accru de diabète a été rapportée, insistant sur le rôle de l'insulinorésistance. Pourtant, certains cas de diabète se développent indépendamment de toute prise pondérale, avec une évolution...

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Glucose Intolerance with Atypical Antipsychotics

Abstract: Treatment with clozapine, olanzapine or risperidone appears to be associated with an increased risk of glucose intolerance.

Cited by 107 publications

References 34 publications

Diabetes mellitus in the extreme longevity

Diabetes mellitus in the extreme longevity

Effects of Olanzapine and Ziprasidone on Glucose Tolerance in Healthy Volunteers

Abnormal glucose metabolism in patients treated with antipsychotics

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