Can Diabetes Mellitus Be Induced by Medication?

Abstract

The possible relation between diabetes mellitus and the use of psychotropic medications in adult psychiatric patients has been discussed in the literature. In child and adolescent psychiatry, however, there have been only two previous case reports of an adolescent who developed diabetes mellitus while receiving psychotropic medications. We present three adolescents who developed diabetes mellitus after combined treatment with divalproex sodium and atypical antipsychotics. All were African American, obese, and had a family history of diabetes mellitus. We discuss each case and examine the possibility of psychotropic medication-induced diabetes mellitus in adolescents.

Newer antipsychotic drugs and obesity in children and adolescents. How should we assess drug‐associated weight gain?

“…Saito and Kafantaris (25) looked for an association between newer antipsychotic drugs and diabetes mellitus in adolescents. In their first case, a 13‐year‐old Black male received risperidone and divalproex and gained 15.4 kg in 12 weeks.…”

“…In our review of children and adolescents experiencing antipsychotic drug‐associated obesity, in the US most of the reports involved risperidone (13, 14, 16, 18–22, 24–26, 28). Between 1998 and 2002, the estimated antipsychotic drug prescriptions dispensed for adults was very similar for risperidone and olanzapine in the US (31).…”

“…Saito and Kafantaris (25) reported three adolescents who developed diabetes mellitus while receiving either risperidone (two cases) or quetiapine (one case) and divalproex. Each subject was obese, Black, and had a family history of diabetes mellitus.…”

Metabolic Implications of Psychotropic Medications in a Publicly-Funded State Psychiatric Hospital

“…Considering associated high morbidity and mortality of these conditions, it has become imperative to monitor the metabolic status of patients treated with atypical antipsychotics (Almeras et al 2004;Meyer and Koro, 2004). All atypical antipsychotics have received a black box warning urging physicians to monitor glucose status of patients receiving treatment ("Physicians' Desk Reference," 2005), even though it has been diffi cult to demonstrate a causal link between antipsychotics and glucose abnormalities (Saito and Kafantaris, 2002) due to the increased background risk of diabetes mellitus in patients with schizophrenia and the increasing incidence of diabetes mellitus in the general population.…”

A Double-Edged Sword: Atypical Antipsychotics in Child and Adolescent Psychiatry

“…It took approximately seven years for the first reports of tardive dyskinesia (TD) to emerge with the typical antipsychotics and no one knows if this will also be true for the atypical antipsychotics with TD or there will be other adverse effects. Although many child psychiatrists noticed the large weight gain in patients treated with olanzapine right away, it is now starting to emerge that these weight gains may actually produce diabetes in some patients (Saito & Kafantaris 2002). The more these agents are used in a broader range of patients, the more likely it is that similar unforeseen, long-term adverse effects will emerge.…”