Antipsychotics and Diabetes: An Age-Related Association

Hammerman, Ariel; Dreiher, Jacob; Klang, Shmuel; Munitz, Hanan; Cohen, Arnon D.; Goldfracht, Margalit

doi:10.1345/aph.1l015

Cited by 70 publications

(41 citation statements)

References 34 publications

(37 reference statements)

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“…Similar to many studies of healthy children, adolescents, and adults, we also found that subjects with type 1 diabetes and with antipsychotic medication had increased weight (8)(9)(10)(11)(12)(13). Interestingly, our survey showed an increased BMI with both typical and atypical antipsychotic treatment.…”

Section: Discussionsupporting

confidence: 89%

“…In addition to the extrapyramidal symptoms caused by typical antipsychotics, the adverse metabolic effects of atypical antipsychotics are of concern (8)(9)(10)(11)(12)(13)(14). The use of atypical antipsychotics may result in weight gain, changes in lipid concentrations, increased glucose concentrations, and insulin resistance in healthy subjects (8)(9)(10)(11)(12)(13)(14). Weight gain occurs in up to 50% of patients receiving longterm treatment for schizophrenia (8).…”

mentioning

confidence: 99%

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Comparison of Glycemic and Metabolic Control in Youth With Type 1 Diabetes With and Without Antipsychotic Medication: Analysis From the Nationwide German/Austrian Diabetes Survey (DPV)

et al. 2015

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OBJECTIVEThe objective of this study was to explore metabolic risk factors and glycemic control in youth with type 1 diabetes treated with typical or atypical antipsychotics. RESEARCH DESIGN AND METHODSData for 60,162 subjects with type 1 diabetes up to the age of 25 years registered in the nationwide German/Austrian Diabetes Survey were included in the analysis. BMI; HbA 1c ; treatment strategy; prevalence of hypertension, dyslipidemia, microalbuminuria, and retinopathy; frequency of hypoglycemia and diabetic ketoacidosis (DKA); and immigrant status among subjects treated with typical or atypical antipsychotics were compared with those without antipsychotic medication and analyzed by regression analysis. RESULTSA total of 291 subjects with type 1 diabetes (median diabetes duration 7.2 years) received antipsychotic medications (most commonly risperidone). Subjects treated with antipsychotics had a higher BMI (P = 0.004) and dyslipidemia was more frequent (P = 0.045) compared with subjects not receiving antipsychotic medication. Frequencies of severe hypoglycemia and DKA were significantly higher in subjects receiving antipsychotics (P < 0.001). The prevalences of hypertension, microalbuminuria, and retinopathy were not different. In subjects treated with typical antipsychotics, glycemic control did not differ compared with those who did not receive antipsychotic medications. By contrast, subjects treated with atypical antipsychotics had higher HbA 1c levels (P = 0.022). CONCLUSIONSThis analysis from a real-life survey demonstrated that subjects with antipsychotic medication had worse glycemic control and a higher rate of acute complications compared with those without antipsychotic medication. Health care teams caring for youth with type 1 diabetes taking antipsychotic medication need to know about these findings. We suggest monitoring metabolic risk factors as well as providing diabetes education about prevention of acute complications.

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Section: Discussionsupporting

confidence: 89%

mentioning

confidence: 99%

Comparison of Glycemic and Metabolic Control in Youth With Type 1 Diabetes With and Without Antipsychotic Medication: Analysis From the Nationwide German/Austrian Diabetes Survey (DPV)

et al. 2015

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“…The findings are consistent with results from controlled trials [25][26][27] and epidemiology studies 31 that demonstrated early onset and rapid progression of metabolic risk factors after antipsychotic treatment in children. The fact that only a few children were screened suggests that actual rates of metabolic abnormalities in these settings may be higher and that claimsbased estimates available to state policy makers may underestimate true rates of these problems.…”

Section: Commentsupporting

confidence: 89%

“…24 Relatively little information exists regarding the shortterm and long-term metabolic effects of antipsychotic use in children, 25 although initial observations indicate that metabolic adverse effects of antipsychotic treatment in pediatric populations are readily detected. [26][27][28][29][30][31] Compared with adults, children who take olanzapine, risperidone, and quetiapine fumarate are particularly at risk for weight gain. [28][29][30][31] Type 2 diabetes and cardiovascular adverse events have also been identified in children and adolescents exposed to antipsychotics, especially when multiple antipsychotics are prescribed or antipsychotics are coprescribed with mood stabilizers and antidepressants.…”

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confidence: 99%

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Metabolic Screening in Children Receiving Antipsychotic Drug Treatment

Morrato¹,

Nicol²,

Maahs³

et al. 2010

Arch Pediatr Adolesc Med

135

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National Trends in the Office-Based Treatment of Children, Adolescents, and Adults With Antipsychotics

Olfson¹,

Blanco²,

Liu³

et al. 2012

Arch Gen Psychiatry

319

296

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CONTEXT Although antipsychotic treatment has recently increased, little is known about how this development has differentially affected the office-based care of adults and young people in the United States. OBJECTIVE To compare national trends and patterns in antipsychotic treatment of adults and youths in office-based medical practice. DESIGN Trends between 1993 and 2009 in visits with antipsychotics for children (0-13 years), adolescents (14-20 years), and adults (≥21 years) are described on a per population basis and as a proportion of total medical office visits. Background and clinical characteristics of recent (2005-2009) antipsychotic visits are also compared by patient age. SETTING Outpatient visits to physicians in office-based practice. PARTICIPANTS Visits from the 1993-2009 National Ambulatory Medical Care Surveys (N = 484 889). MAIN OUTCOME MEASURES Visits with a prescription of antipsychotic medications. RESULTS Between 1993-1998 and 2005-2009, visits with a prescription of antipsychotic medications per 100 persons increased from 0.24 to 1.83 for children, 0.78 to 3.76 for adolescents, and 3.25 to 6.18 for adults. The proportion of total visits that included a prescription of antipsychotics increased during this period from 0.16% to 1.07% for youths and from 0.88% to 1.73% for adults. From 2005 to 2009, disruptive behavior disorders were the most common diagnoses in child and adolescent antipsychotic visits, accounting for 63.0% and 33.7%, respectively, while depression (21.2%) and bipolar disorder (20.2%) were the 2 most common diagnoses in adult antipsychotic visits. Psychiatrists provided a larger proportion of the antipsychotic visits for children (67.7%) and adolescents (71.6%) than to adults (50.3%) (P < .001). From 2005 to 2009, antipsychotics were included in 28.8% of adult visits and 31.1% of youth visits to psychiatrists. CONCLUSIONS On a population basis, adults make considerably more medical visits with a prescription of antipsychotics than do adolescents or children. Yet antipsychotic treatment has increased especially rapidly among young people, and recently antipsychotics have been prescribed in approximately the same proportion of youth and adult visits to psychiatrists.

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Antipsychotics and Diabetes: An Age-Related Association

Cited by 70 publications

References 34 publications

Comparison of Glycemic and Metabolic Control in Youth With Type 1 Diabetes With and Without Antipsychotic Medication: Analysis From the Nationwide German/Austrian Diabetes Survey (DPV)

Comparison of Glycemic and Metabolic Control in Youth With Type 1 Diabetes With and Without Antipsychotic Medication: Analysis From the Nationwide German/Austrian Diabetes Survey (DPV)

Metabolic Screening in Children Receiving Antipsychotic Drug Treatment

National Trends in the Office-Based Treatment of Children, Adolescents, and Adults With Antipsychotics

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