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Atypical antipsychotics and diabetes mellitus
Peter Schwenkreis1, Hans-Jörg Assion
1Department of Psychiatry and Psychotherapty, Ruhr-University of Bochum, Germany.
Summary
Atypical antipsychotics may increase the risk of developing diabetes mellitus (DM). Patients on these medications, especially clozapine or olanzapine, require monitoring for glucose metabolism abnormalities.
Area of Science:
- Neuroscience
- Endocrinology
- Pharmacology
Background:
- Growing concern regarding the diabetogenic effects of novel antipsychotics.
- Lack of large prospective studies on atypical antipsychotics and glucose metabolism.
- Existing case reports and retrospective studies suggest an increased risk of diabetes mellitus (DM).
Purpose of the Study:
- To review existing literature on the relationship between atypical antipsychotics and impaired glucose metabolism.
- To assess the risk of developing DM in patients treated with atypical antipsychotics.
- To explore potential mechanisms and recommend monitoring strategies.
Main Methods:
- Review of case reports and retrospective studies.
- Comparison of DM risk in patients treated with atypical antipsychotics versus conventional antipsychotics or no treatment.
- Analysis of potential diabetogenic mechanisms.
Main Results:
- Atypical antipsychotics are associated with an increased risk of developing DM compared to controls.
- Clozapine and olanzapine may pose a higher risk than risperidone; data on quetiapine and ziprasidone is limited.
- Potential mechanisms include insulin resistance, pancreatic beta-cell dysfunction, and receptor antagonism.
Conclusions:
- Atypical antipsychotics may increase DM risk, potentially by hastening onset in predisposed individuals.
- Monitoring for glucose abnormalities is recommended before and during atypical antipsychotic therapy.
- Further research is needed for quetiapine and ziprasidone regarding their diabetogenic potential.