The time-dependent change of insulin secretion in schizophrenic patients treated with olanzapine

Chiu, Chih Chiang; Chen, Chun Hsin; Chen, Bo Yu; Yu, Shu; Lu, Mong Liang

doi:10.1016/j.pnpbp.2010.04.003

Cited by 39 publications

(32 citation statements)

References 48 publications

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“…96 In another study in schizophrenia patients who started or switched to a different APD for 3 months, a time-dependent worsening of plasma glucose levels was observed in subjects taking clozapine, olanzapine and quetiapine.…”

mentioning

confidence: 96%

Effects of Antipsychotic Medications on Appetite, Weight, and Insulin Resistance

Deng¹

2013

Endocrinology and Metabolism Clinics of North America

144

100

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Although clozapine, olanzapine, and other atypical antipsychotic drugs (APDs) have fewer extrapyramidal side effects, they have serious metabolic side effects such as substantial weight gain, intra-abdominal obesity, and type 2 diabetes mellitus. Given that most patients with mental disorders face chronic, even life-long, treatment with APDs, the risks of weight gain/obesity and other metabolic symptoms are major considerations for APD maintenance treatment. This review focuses on the effects of APDs on weight gain, appetite, insulin resistance, and glucose dysregulation, and the relevant underlying mechanisms that may be help to prevent and treat metabolic side effects caused by APD therapy.

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mentioning

confidence: 96%

Effects of Antipsychotic Medications on Appetite, Weight, and Insulin Resistance

Deng¹

2013

Endocrinology and Metabolism Clinics of North America

144

100

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“…Perez-Iglesias et al reported a non-significant drop in serum adiponectin levels, although they did find a significant increase in the serum insulin and leptin levels and patient weight after one year of treatment with atypical antipsychotics [30]. Studies focused on the correlation of atypical antipsychotics with weight gain and insulin resistance have shown that occasionally there is no significant difference among the atypical antipsychotics and that Olanzapine and Clozapine have more involvement with weight gain and the disruption of glucose regulation [31][32][33][34] than other drugs. Crespo-Facorro et al determined that, although there is no difference in efficacy and tolerability, Olanzapine causes more weight gain compared to Risperidone [35], and Van Winkel et al have drawn attention to the fact that Clozapine carried the highest risk of changing plasma glucose levels among schizophrenia and schizoaffective disorder patients using Risperidone, Aripiprazole or Clozapine [36].…”

Section: Discussionmentioning

confidence: 98%

The Effects of Atypical Antipsychotic Usage Duration on Serum Adiponectin Levels and Other Metabolic Parameters

Oral

Güleç

Kurt

et al. 2011

EAJM

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Objective: Although atypical antipsychotics are well-tolerated and eff ective treatment options for schizophrenia, they have metabolic side eff ects, including weight gain and increased risk of Type II Diabetes Mellitus (DM). Adiponectin, produced exclusively in adipocytes, is the most abundant serum adipokine. Low levels of adiponectin are correlated with DM, insulin resistance and coronary heart disease. Usage of atypical antipsychotics may create a risk of metabolic syndrome. The aim of this study was to evaluate the eff ects of antipsychotic usage on parameters related to development of metabolic syndrome. Materials and Methods:A total of 27 patients (n=27) (13 women and 14 men) were recruited from our out-patient psychiatry clinic. All patients had been treated with atypical antipsychotics for at least 3 months and were in remission. Patients were evaluated for levels of HDL (High Density Lipoprotein), LDL (Low Density Lipoprotein ), TG (Triglyceride) total cholesterol and fasting blood glucose, body weight, BMI (Body Mass Index), waist circumference and serum adiponectin levels.Results: Serum adiponectin levels were signifi cantly lower (p:0.000) and body weights were signifi cantly higher (p:0.003) in the patients who had been using atypical antipsychotics for longer than a year in comparison to patients who had been using atypical antipsychotics for one year or less. Conclusion:Our fi ndings supported the hypothesis that the length of administration of atypical antipsychotics has an eff ect on metabolic changes. They also highlight the fact that when investigating metabolic changes generated by atypical antipsychotic eff ects, the length of time that the patient has been on the atypical antipsychotics should also be considered.

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“…Chiu et al [6] found that in schizophrenic patients treated with olanzapine for 8 weeks, insulin secretion significantly decreased at week 2, returned to baseline at week 4, and significantly increased at week 8, and therefore concluded that olanzapine displayed time-dependent biphasic changes in insulin secretion to a hyperglycemic challenge. We have previously reported the case of an overweight Japanese female patient in which switching from olanzapine to risperidone and one month of insulin therapy resulted in a decrease in the fasting blood glucose level and an increase in the insulin level [7].…”

Section: Discussionmentioning

confidence: 99%

Olanzapine-induced severe hyperglycemia was completely reversed by the restoration of insulin secretion after switching to aripiprazole and initiating insulin therapy

Nakamura¹,

Masaoka²,

Nagamine

2014

CNPT

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A 54-year-old Japanese man who had received a diagnosis of schizophrenia and been treated with olanzapine for nearly 16 months consulted our department because of severe hyperglycemia (535 mg/dL). The use of antipsychotics, switching the patient from olanzapine to aripiprazole, and 7 weeks of insulin therapy resulted in a decrease in the patient's postprandial blood glucose levels and an increase in his postprandial C-peptide levels (442 mg/dL to 106 mg/dL and 1.72 ng/mL to 4.94 ng/mL, respectively) as well as an improvement in his pre-prandial levels (250 mg/dL to 85 mg/dL and 1.00 ng/mL to 1.69 ng/mL, respectively) with almost no change in the 24-hour urinary excretion of C-peptide. These results suggested that an insufficiency of insulin secretion, not insulin resistance, was associated with the patient's severe hyperglycemia, and that olanzapine-induced pancreatic β-cell impairment might be reversible if the hyperglycemia is diagnosed and treated sufficiently early. When prescribing second-generation antipsychotics such as olanzapine, clinicians should take the level of insulin into account in addition to monitoring serum glucose levels.

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The time-dependent change of insulin secretion in schizophrenic patients treated with olanzapine

Cited by 39 publications

References 48 publications

Effects of Antipsychotic Medications on Appetite, Weight, and Insulin Resistance

Effects of Antipsychotic Medications on Appetite, Weight, and Insulin Resistance

The Effects of Atypical Antipsychotic Usage Duration on Serum Adiponectin Levels and Other Metabolic Parameters

Olanzapine-induced severe hyperglycemia was completely reversed by the restoration of insulin secretion after switching to aripiprazole and initiating insulin therapy

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