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New onset diabetes and atypical antipsychotics.
K A Liebzeit1, J S Markowitz, C F Caley
1College of Pharmacy, Medical University of South Carolina, Charleston, SC 29425, USA.
Summary
Atypical antipsychotics, like clozapine and olanzapine, may increase the risk of new-onset diabetes or glucose dyscontrol. This risk is significant even at standard doses, warranting careful monitoring in patients with psychotic disorders.
Area of Science:
- Psychopharmacology
- Endocrinology
- Metabolic Disorders
Background:
- Atypical antipsychotics are primary treatments for psychotic disorders.
- Both schizophrenia and older antipsychotics have historical links to glucose control issues.
- Diabetes is associated with cardiovascular disease, highlighting the importance of glucose monitoring.
Purpose of the Study:
- To review literature on antipsychotic medications and glucose-insulin problems.
- To identify specific atypical antipsychotics associated with diabetes risk.
- To examine reported cases of antipsychotic-induced diabetes.
Main Methods:
- Conducted computerized searches of Medline and Current Contents (1966-June 2000).
- Retrieved studies and case reports on typical and atypical antipsychotics.
- Focused on adverse events related to glucose-insulin metabolism.
Main Results:
- Thirty-five cases of drug-induced or exacerbated diabetes were found.
- Clozapine (20 cases) and olanzapine (15 cases) were most frequently implicated.
- Diabetic ketoacidosis was a common presenting symptom, occurring at standard antipsychotic doses.
Conclusions:
- Atypical antipsychotics, particularly clozapine and olanzapine, are associated with new-onset diabetes or glucose dyscontrol.
- The risk exists even with standard medication dosages.
- Further attention to glucose monitoring in patients on these medications is crucial.