Risk of Treatment-Emergent Diabetes Mellitus in Patients Receiving Antipsychotics

Abstract

Based on the published pharmacoepidemiologic reports reviewed, the avoidance of diabetes as an outcome cannot be predictably achieved with precision by choice of a second-versus a first-generation antipsychotic. Risk management for new-onset diabetes requires the assessment of established risk factors such as family history, advancing age, non-white ethnicity, diet, central obesity, and level of physical activity.

Antipsychotics Associated with the Development of Type 2 Diabetes in Antipsychotic-Naïve Schizophrenia Patients

“…Initial treatment with low-potency FGA was not associated with an increased risk of diabetes, which might be due to low numbers. Rather, medications should be considered separately, or grouped by individual cardiometabolic risk, which cuts across SGAs and FGAs (Citrome et al, 2007;Hagg et al, 1998).…”

Antipsychotics-induced metabolic alterations: Focus on adipose tissue and molecular mechanisms

“…A combination of genetic and environmental factors is likely to be involved in the dysregulation of glucose metabolism observed in these patients. Moreover, an important factor involved is antipsychotic drugs consumption (reviewed in Citrome et al, 2007;Jin et al, 2004). The association between antipsychotics consumption and disturbances in glucose metabolism dates back to 1955, when it was shown that diabetic mice treated with the typical antipsychotic chlorpromazine developed higher blood glucose levels and presented an increase in mortality in comparison with diabetic mice not receiving the drug (Norman and Hiestand, 1955).…”

Testing for type 2 diabetes in Indigenous Australians: guideline recommendations and current practice

“…Data from a recent meta-analysis of 25 observational pharmaco-epidemiologic studies found no significant difference in the risk of developing treatment-emergent type 2 diabetes using either second-generation or first-generation antipsychotics (Citrome et al, 2007). However, there are limited data on two recent second-generation antipsychotics, aripiprazole and ziprasidone.…”