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Olanzapine-associated diabetes mellitus
Elizabeth A Koller1, P Murali Doraiswamy
1Division of Metabolic and Endocrine Drug Products, Center for Drug Evaluation and Review, Food and Drug Administration, Rockville, Maryland, USA.
Pharmacotherapy
|July 20, 2002
Summary
Olanzapine therapy may cause new-onset diabetes or worsen existing diabetes, particularly within six months of treatment. Discontinuing olanzapine often improves hyperglycemia, suggesting a link between the drug and diabetes risk.
Area of Science:
- Pharmacovigilance
- Endocrinology
- Psychiatry
Background:
- Olanzapine is an atypical antipsychotic used for various psychiatric conditions.
- Hyperglycemia and diabetes mellitus are potential adverse effects associated with some antipsychotic medications.
Purpose of the Study:
- To investigate the clinical presentation and characteristics of hyperglycemia in patients treated with olanzapine.
- To explore the potential causal relationship between olanzapine use and the development or exacerbation of diabetes.
Main Methods:
- A retrospective, epidemiologic survey of spontaneously reported adverse events related to olanzapine therapy.
- Data were collected from the US Food and Drug Administration's MedWatch system and published literature (MEDLINE, meeting abstracts).
- Analysis included 237 patients with olanzapine-associated diabetes or hyperglycemia.
Main Results:
- Of 237 cases, 188 were new-onset diabetes and 44 were exacerbations of pre-existing diabetes.
- Hyperglycemia typically appeared within 6 months of starting olanzapine therapy (73% of cases).
- Improved glycemic control was observed in 78% of patients after olanzapine discontinuation or dose reduction, with recurrence in 80% upon rechallenge.
Conclusions:
- The temporal association with olanzapine initiation, improvement upon withdrawal, and occurrence in relatively young patients suggest olanzapine may precipitate or unmask diabetes in susceptible individuals.
- These findings highlight the importance of monitoring glucose levels in patients receiving olanzapine.
- Further research may be warranted to elucidate the precise mechanisms underlying olanzapine-induced hyperglycemia.