Association of Low-Dose Quetiapine and Diabetes

Lund, Lars Christian; Andersen, Kjeld; Correll, Christoph U.; Hallas, Jesper

doi:10.1001/jamanetworkopen.2021.3209

Cited by 15 publications

(14 citation statements)

References 41 publications

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“…When analysing the above data, it should be considered that most studies assessing the diabetogenic potential of antipsychotic drugs do not take into account their daily dose. For example, Højlund et al revealed that low-dose (25 250 mg) quetiapine was not associated with higher risk of DM [9]. The use of antipsychotics such as aripiprazole, risperidone, haloperidol, and olanzapine has also been shown to be associated with the risk of IGT, and in the case of clozapine, haloperidol, and olanzapine -also of IFG development [10][11][12].…”

Section: Diagnostics Of Carbohydrate Metabolism Disordersmentioning

confidence: 99%

Diagnosis and management of hyperglycaemia in patients treated with antipsychotic drugs

et al. 2022

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This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commerciallyThe Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 reported that mental disorders accounted for 654.8 million estimated cases in 1990 and 970.1 million cases in 2019 (an increase of 48.1%) [5]. A review and meta-analysis perform by Jongsma et al. showed that the prevalence of all psychotic disorders was 26.6 per 100,000 person-years [6]. It is estimated that DM can affect 8.7% with major depressive disorders, 6.2% with bipolar disorders, and 12% of patients with severe mental illnesses (schizophrenia, depression, bipolar and psychotic disorders). A high (19%) incidence of "prediabetic conditions" in patients with various types of psychoses has also been observed [7]. A recent study by Liu et al. indicates that patients with bipolar disorders have nearly 1.6 times greater risk of developing DM [8]. These data may be underestimate to the real risk of antipsychotic drugs. This is because they often do not take into account the presence of undiagnosed type 2 diabetes before using antipsychotic drugs.

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Section: Diagnostics Of Carbohydrate Metabolism Disordersmentioning

confidence: 99%

Diagnosis and management of hyperglycaemia in patients treated with antipsychotic drugs

et al. 2022

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“…In another study with quetiapine dosing up to 100 mg/d, body weight increased after 6 and 12 months of use 40 . However, in a large Danish register study, low‐dose quetiapine did not associate with excess risk of type 2 diabetes in comparison with selective serotonin reuptake inhibitors 41 . The long‐term effects of low doses of APs in off‐label use need further exploration.…”

Section: Discussionmentioning

confidence: 93%

Characteristics and predictors of off‐label use of antipsychotics in general population sample

Pirhonen

Haapea

Rautio

et al. 2022

Acta Psychiatr Scand

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Objective: Increasing number of people have been prescribed antipsychotics (APs) off-label in recent decades. This study aimed to identify the characteristics and predictors of receiving prescription of antipsychotics off-label. Methods: The study sample was part of the Northern Finland Birth Cohort 1966 (n = 7071). Data included questionnaires and national register data.Information on prescribed medications was extracted from the national register. The sample was divided into three groups: Persons who had been prescribed APs off-label (n = 137), individuals with non-psychotic mental disorders without APs off label (n = 1478) and individuals who had been diagnosed with psychosis or bipolar disorder and who had been prescribed APs (n = 151). We compared sociodemographic, lifestyle and clinical characteristics between the off-label and the comparison groups using logistic regression. Results:The most common diagnoses in the off-label group were depression (n = 96, 70.1%) and anxiety (n = 55, 40.1%). Compared with individuals with non-psychotic mental disorders who were not prescribed APs off-label, individuals with prescribed off-label APs had a lower level of education, lower socioeconomic status, were less often married, had a higher level of somatic and psychiatric morbidity, were more often smokers and more often had a substance abuse disorder and heavy alcohol consumption. When comparing the off-label group to individuals with psychosis or bipolar disorder who used APs, there were less differences, though individuals with psychosis or bipolar disorder had more markers of morbidity and a lower level of education. Conclusion:Individuals who had been prescribed APs off label had a higher level of mental and somatic morbidity and poorer socioeconomic status than individuals with non-psychotic mental disorders who did not use APs.

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“…A Canadian study 6 has explored physicians’ reasons for use of quetiapine and found complex psycho‐social needs, the positive attitude of colleagues towards quetiapine, and the apparent absence of adverse events with low doses, to be potential explanations for off‐label use of quetiapine. Additionally, low‐dose use of quetiapine has not been associated with increased risk of diabetes 15 or increased risk of dependency, although reports accumulate on extramedical use of quetiapine 16 . Additionally, the high prevalence (and low average doses) among those aged ≥80 years together with the substantial proportion of quetiapine being prescribed by general practitioners might suggest that quetiapine is used for treatment of off‐label conditions as behavioural and psychological symptoms of dementia.…”

Section: Discussionmentioning

confidence: 99%

Who prescribes quetiapine in Denmark?

Rasmussen

Olesen

Munk‐Olsen

et al. 2022

Brit J Clinical Pharma

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The second-generation antipsychotic quetiapine is commonly used off-label for its anxiolytic and hypnotic properties. However, quetiapine is associated with problematic side-effects. We used Danish Medicinal Product Statistics and a 20% random sample of the Danish population's prescription fills (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019)(2020) to describe the utilization of quetiapine and proportion of various prescriber types (general practitioner [GP], specialist in private practice, hospital physician and other prescribers) both in connection to first-time and subsequent prescriptions. In 2020, 92% of all quetiapine was dispensed outside hospitals and the average daily dispensed quantity of quetiapine per user corresponded to 100 mg/user/d. A GP issued 53% of first-time prescriptions and 75% of subsequent prescriptions for quetiapine in 2020. The proportion of quetiapine prescriptions issued by GPs varied by age group-from 14% among 0-17-year-olds to 93% among the ≥80-year-olds. Future initiatives on the rational use of quetiapine and related drugs, especially among adults, should target GPs.

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Association of Low-Dose Quetiapine and Diabetes

Cited by 15 publications

References 41 publications

Diagnosis and management of hyperglycaemia in patients treated with antipsychotic drugs

Diagnosis and management of hyperglycaemia in patients treated with antipsychotic drugs

Characteristics and predictors of off‐label use of antipsychotics in general population sample

Who prescribes quetiapine in Denmark?

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