Diabetes, Psychiatric Disorders, and the Metabolic Effects of Antipsychotic Medications

Llorente, Maria D.; Urrutia, Victoria

doi:10.2337/diaclin.24.1.18

Cited by 65 publications

(56 citation statements)

References 45 publications

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“…The relative receptor affinity of SGAs for dopamine, serotonin and histamine receptors leading to increased eating and weight gain have been suggested to be an underlying cause. 8,12 In the present investigation, after 4 weeks treatment with risperidone and quetiapine there was significant rise in blood glucose level. After 8 and 12 weeks treatment all the three drugs significantly increased in blood glucose level; whereas overall change in blood glucose significant, in all the three groups.…”

Section: Discussionmentioning

confidence: 76%

“…Other causes such as disruption of hypothalamic regulation of glucose levels may be responsible for medication induced diabetes. 8 Transmission mediated by α-adrenergic receptors seems to have an effect on stimulation of appetite. Blockade of H1 receptors is involved in increased appetite and consequent weight gain 12 .…”

Section: Introductionmentioning

confidence: 99%

“…For positive symptoms of schizophrenia, the effectiveness of these drugs appears to be comparable to that of older agents. [8][9][10] Recently there has been considerable interest and concern about the metabolic abnormalities associated with SGAs use 11 . Antipsychotics can lead to increased appetite by interfering with the dopamine reward system.…”

Section: Introductionmentioning

confidence: 99%

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Metabolic risk factor profile in patients on treatment with second generation antipsychotics

Zahan

Akhter

Mullick

et al. 2016

Bangladesh Med Res Counc Bull

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The second generation antipsychotic agents, although exhibit superior safety profile, is associated with metabolic adverse effects including weight gain, diabetes mellitus and hyperlipidaemia. These adverse effects are not only the risk factors for cardiovascular disease and diabetes mellitus but may also impair patient's adherence to treatment. However, different member of second generation antipsychotics differ in their extent of metabolic adverse effects. The aim of the study was to evaluate the association between olanzapine, risperidone or quetiapine treatment and body mass index, blood pressure, diabetes mellitus and hyperlipidaemia in patients with Schizophrenia and Bipolar Disorder. Forty-four cases of Schizophrenia and Bipolar Disorder diagnosed with DSM-IV criteria were selected according to inclusion and exclusion criteria. Body weight, body mass index and blood pressure were measured at baseline, at the end of 4th, 8th and 12th weeks of treatment. Blood samples were collected to measure blood glucose and serum lipid profile at baseline and at the end of 4th, 8th and 12th weeks in the study group receiving treatment (olanzapine 20-30 mg/day, risperidone 4-16 mg/day and quetiapine 300-800 mg/day) after overnight fasting. Therapeutic use of olanzapine and risperidone in Schizophrenia and Bipolar Disorder for a period of 4th, 8th and 12th weeks was associated with significant increase in body weight and body mass index. Quetiapine did not cause significant changes in body weight and body mass index after 4 and 8 weeks. However, after 12 weeks treatment, body mass index increased significantly. Olanzapine, risperidone and quetiapine increased the blood glucose level significantly after 8 and 12 weeks treatment. Olanzapine and risperidone elevated the serum cholesterol, triglyceride and low density lipoprotein levels significantly after 4, 8 and 12 weeks. But quetiapine showed no significant change in lipid profile. However, olanzapine and risperidone significantly increased triglyceride level after 8 and 12 weeks. Amongst three drugs, quetiapine treatment increased high density lipoprotein level. Our study revealed that quetiapine treatment is associated with less risk of dyslipidaemia.

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Section: Discussionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Metabolic risk factor profile in patients on treatment with second generation antipsychotics

Zahan

Akhter

Mullick

et al. 2016

Bangladesh Med Res Counc Bull

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“…68 LDL dyslipidaemia was significantly associated with schizophrenia, possibly since 50% of LDLdyslipidaemia-afflicted patients were taking sodium valproate and 32% were taking clozapine. The prevalent use of sodium valproate in these patients with schizophrenia is an area of concern that deserves further study.…”

Section: Dyslipidaemiamentioning

confidence: 99%

The prevalence of metabolic syndrome and its associated factors in long-term patients in a specialist psychiatric hospital in South Africa

et al. 2013

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Objective: The aims of this study were to determine the prevalence of metabolic disorders in long-term psychiatric patients, and the relationship between known risk factors and these metabolic disorders. Method: All psychiatric in-patients ≥18 years, who had been admitted ≥six months were invited to participate. Eighty-four patients participated. They were interviewed, examined, measured and blood tests conducted to determine several demographic and clinical variables including age, gender, weight, blood pressure and fasting blood glucose. Results: The prevalence of the metabolic disorders were: metabolic syndrome 32%, hypertension 32%, diabetes mellitus 8%, cholesterol dyslipidaemia 32%, triglyceride dyslipidaemia 29%, low density lipoprotein (LDL) dyslipidaemia 50%, overweight 37%, and obesity 24%. Black African and female patients were more likely to have metabolic syndrome. Female patients were more likely to have cholesterol dyslipidaemia and obesity. Hypertension was associated with age. Ninety-six percent of patients with dyslipidaemia were newly diagnosed during the study. Three out of the seven previously diagnosed diabetic patients had raised fasting blood glucose levels. Conclusion: The prevalence of metabolic syndrome falls towards the lower limits of the expected prevalence rate. Race and gender showed a moderate statistical association with metabolic syndrome. There is a lack of screening for dyslipidaemia in this setting. Diabetic patients should be referred to specialist diabetic clinics for better monitoring and control. developing countries. 20,21 Therefore, the first aim of the study was to determine the local prevalence of these metabolic disorders in long-term psychiatric patients.Many studies like CATIE have found a significant association between some second-generation antipsychotics (SGA) and weight gain, diabetes mellitus and dyslipidaemia. [22][23][24][25][26][27][28] However, the contribution of other variables including first-generation antipsychotics (FGA), mood stabilisers and antidepressants in the development of metabolic disorders has also been recognised. [29][30][31][32][33][34] Unmodifiable risk factors (age, ethnicity, gender and family history) and modifiable ones (level of functioning, smoking history, dietary intake and obesity) in psychiatric patients have also been associated with metabolic disorders. [35][36][37] Therefore, the second aim of the study was to determine whether these risk factors could be associated with metabolic disorders in long-term psychiatric patients.Although screening guidelines for these disorders have been recommended due to the significance of metabolic disorders in causing CVD, the guidelines are still not widely applied, even in developed countries. 38,39 Clinicians tend to rely on a patient's presentation of worrying symptoms/signs or in the case of inpatients, routine monthly blood pressure checking before investigating or treating these disorders. As a result, opportunities to detect and treat metabolic disorders may be missed. The...

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“…It has been shown that individuals with diabetes have a disproportionately higher rate of psychiatric disorders (Bogner et al, 2007;Llorente & Urrutia, 2006), with affective and anxiety disorders being more commonly diagnosed than in the general population (De Mont-Marin et al, 1995). This is evidenced by research showing high rates of psychiatric disorders, particularly depression and anxiety, for example, Fettahoglu et al, (Fettahoglu et al, 2007) found over 40% increased risk in having any type of psychiatric disorder in patients with diabetes, and Gülseren et al (Gülseren et al, 2001) found that depression and anxiety account for 45% of psychiatric disorders in patients with diabetes.…”

mentioning

confidence: 99%

Inadequate Coping Attitudes, Disordered Eating Behaviours and Eating Disorders in Type 1 Diabetic Patients

García‐Mayor¹,

Larrañaga²

2011

Type 1 Diabetes - Complications, Pathogenesis, and Alternative Treatments

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Diabetes, Psychiatric Disorders, and the Metabolic Effects of Antipsychotic Medications

Cited by 65 publications

References 45 publications

Metabolic risk factor profile in patients on treatment with second generation antipsychotics

Metabolic risk factor profile in patients on treatment with second generation antipsychotics

The prevalence of metabolic syndrome and its associated factors in long-term patients in a specialist psychiatric hospital in South Africa

Inadequate Coping Attitudes, Disordered Eating Behaviours and Eating Disorders in Type 1 Diabetic Patients

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