Diabetes Mellitus Associated with Clozapine Therapy

Wehring, Heidi J.; Alexander, Bruce; Perry, Paul J.

doi:10.1592/phco.20.9.844.35201

Cited by 30 publications

(4 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recent reports suggest that newer antipsychotic medications may also contribute to clinically significant hyperglycemia. Hyperglycemia, exacerbation of existing diabetes, new-onset type 2 diabetes, and diabetic ketoacidosis have all been associated with newer antipsychotic medications, with multiple reports for clozapine [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] and olanzapine, 34,[44][45][46][47][48] and more limited reports of significant hyperglycemia for quetiapine [49][50][51] and risperidone. [52][53][54] Diabetic ketoacidosis, a serious acute complication, is characterized by hyperglycemia, ketosis, and acidosis, with mortality rates ranging from 2% to 20% or higher, depending on factors such as age, social circumstances, and comorbid conditions, especially psychiatric comorbidity.…”

mentioning

confidence: 99%

Abnormalities in Glucose Regulation During Antipsychotic Treatment of Schizophrenia

Newcomer¹,

Haupt²,

Fucetola³

et al. 2002

Arch Gen Psychiatry

465

262

View full text Add to dashboard Cite

show abstract

mentioning

confidence: 99%

Abnormalities in Glucose Regulation During Antipsychotic Treatment of Schizophrenia

Newcomer¹,

Haupt²,

Fucetola³

et al. 2002

Arch Gen Psychiatry

465

262

View full text Add to dashboard Cite

show abstract

“…Most of these cases involved the atypical antipsychotics clozapine [14][15][16][17][18][19][20][21][22][23][24][25][26][27] and olanzapine, 19,[27][28][29][30][31][32][33][34][35] with quetiapine suspected in 2 cases 36,37 and risperidone in 3 cases. [38][39][40] The earlier case literature has also associated some conventional antipsychotics with type 2 diabetes.…”

mentioning

confidence: 99%

Antipsychotic-Induced Type 2 Diabetes: Evidence From a Large Health Plan Database

Gianfrancesco¹,

White²,

Wang³

et al. 2003

Journal of Clinical Psychopharmacology

106

View full text Add to dashboard Cite

Case evidence suggests that some of the atypical antipsychotics may induce type 2 diabetes. The objective of this study was to evaluate the association of antipsychotic treatment with type 2 diabetes in a large health plan database. Claims data for patients with psychosis within a health plan of nearly 2 million members were analyzed using logistic regression. Frequencies of newly treated type 2 diabetes in patients untreated with antipsychotics and among patients treated with quetiapine, risperidone, olanzapine, and conventional antipsychotics were compared. Based on exposure measured in months of antipsychotic treatment, quetiapine and risperidone patients had estimated odds of receiving treatment for type 2 diabetes that were lower than those of patients untreated with antipsychotics (not statistically significant); patients treated with conventional antipsychotics had estimated odds that were virtually equivalent to those of patients untreated with antipsychotics; olanzapine alone had odds that were significantly greater than those of patients untreated with antipsychotics (P = 0.0247). Odds ratios based on 8 months of screening for pre-existing type 2 diabetes and assuming 12 months of antipsychotic treatment were: risperidone = 0.660 (95% CI 0.311-1.408); olanzapine = 1.426 (95% CI 1.046-1.955); quetiapine = 0.976 (95% CI 0.422-2.271); and conventional antipsychotics = 1.049 (95% CI 0.688-1.613). Case reports, prospective trials, and other retrospective studies have increasingly implicated olanzapine and clozapine as causing or exacerbating type 2 diabetes. Few have implicated risperidone while evidence on quetiapine has been limited. This study supports earlier findings on risperidone versus olanzapine and builds evidence on quetiapine. Additional studies are needed to evaluate the association of antipsychotic treatment with type 2 diabetes.

show abstract

“…The relatively short onset time makes a relationship with the agent very likely. In only 2 out of 27 cases on clozapine [90,94], 2 out of 39 on olanzapine [33,65], and 2 out of 4 on risperidone [95], were longer onset times of DM than 1 year mentioned (Fig. 2).…”

Section: Time Of Onset and Reversibilitymentioning

confidence: 92%

Atypical Antipsychotics and New Onset Diabetes mellitus

2004

Pharmacopsychiatry

View full text Add to dashboard Cite

During the last few years, several case reports and studies have been published on the potential diabetes mellitus (DM)-inducing effect of some atypical antipsychotics, especially clozapine and olanzapine. The purpose of our study was to evaluate diabetogenic effects of atypical antipsychotics in the literature. In order to give a full-scale overview, both peer-reviewed publications and oral and poster presentations on this subject were screened. We found 27 case reports of new-onset DM for clozapine, 39 for olanzapine, 4 for risperidone, and 3 for quetiapine. Related to the year of introduction of these drugs on the market and the number of treatment days of each drug during the last 6 years in 13 western countries, Brazil, and Japan, the cases show an over-representation of cases related to olanzapine and clozapine. In the majority of cases, risk factors (DM family history, obesity, Negroid ethnicity) were present. Eighty-four percent of the cases arose in patients < 50 years, in contrast to the general population (most cases, > 50 years). Comparative epidemiological studies point in the same direction, with two studies showing no differences between the atypical drugs. Antipsychotic agents are used often for treatment of schizophrenia, a condition that appears to be associated with DM also in untreated subjects. Some antipsychotics appear to induce new-onset diabetes mellitus. In view of the health risks of DM and the predisposition in patients with schizophrenia, it is advised to be cautious with prescription of antipsychotics that are associated with new-onset DM. Especially in predisposed patients (family history of DM, obese, Negroid ethnicity), reticence in this respect is required. Moreover, careful monitoring of weight, BMI, and glucose levels is advised both before these antipsychotics are prescribed and during treatment.

show abstract

Diabetes Mellitus Associated with Clozapine Therapy

Cited by 30 publications

References 18 publications

Abnormalities in Glucose Regulation During Antipsychotic Treatment of Schizophrenia

Abnormalities in Glucose Regulation During Antipsychotic Treatment of Schizophrenia

Antipsychotic-Induced Type 2 Diabetes: Evidence From a Large Health Plan Database

Atypical Antipsychotics and New Onset Diabetes mellitus

Contact Info

Product

Resources

About