Current and initial treatment with the antipsychotic medications olanzapine, clozapine, or mid- and low-potency first-generation antipsychotics (FGA), increases the risk for Type 2 diabetes in schizophrenia patients, report researchers.
However, current aripiprazole treatment was associated with a decreased risk for Type 2 diabetes.
“Diabetes mellitus occurs in schizophrenia patients at higher rates than in the general population,” write Jimmi Nielsen (Aarhus University, Aalborg, Denmark) and team in the journalNeuropsychopharmacology.
“Reasons for this elevated risk are poorly understood and have not been examined prospectively in antipsychotic-naive, first-episode patients,” they say.
To address this, they assessed diabetes risks in all (n=7139) antipsychotic-naive patients diagnosed with schizophrenia between January 1997 and December 2004. The participants were followed up for 6.6 years on average for incident Type 2 diabetes.
Over the follow-up period 307 patients developed Type 2 diabetes with an annual incidence rate of 0.65%.
Patients who were older, those taking antihypertensive or lipid-lowering drugs, and those who had initial treatment with buy lexapro olanzapine or mid-potency FGAs had a significantly shorter time to onset of diabetes than individuals who were younger and those not treated with these drugs.
Treatment with low-potency FGAs, olanzapine, or clozapine was associated with increased risk for diabetes within 3 months of diabetes development with odds ratios of 1.52, 1.44, and 1.67, respectively. But aripiprazole treatment reduced the relative risk for incident Type 2 diabetes by 49% compared with no aripiprazole treatment.
“The results from this largest cohort study of antipsychotic-naive schizophrenia patients indicate that in addition to general diabetes risk factors, such as higher age, hypertension, and dyslipidemia… diabetes is promoted by initial treatment with olanzapine and mid-potency FGAs, as well as by current treatment with low-potency FGAs, olanzapine, and clozapine,” summarize Nielsen et al.
They suggest that their results indicate that “educational actions and quality control and improvement initiatives should be taken and studied to improve cardiometabolic outcomes in the vulnerable schizophrenia patients.”