Newer Schizophrenia Drugs Increase Diabetes Risk

Results of a study provide more evidence for an association between use of second-generation antipsychotic drugs — in this case olanzapine, quetiapine, and risperidone — and the onset of diabetes. "Dr. Bruce L. Lambert of the University of Illinois at Chicago and colleagues note in a report in the October 1st issue of the American Journal of Epidemiology that, "There is growing evidence of metabolic side effects, such as hyperglycemia and weight gain, following the use of certain second-generation antipsychotic agents.”

"Physicians should be mindful of diabetes risks when treating patients with schizophrenia," they advise.

Dr. Lambert and colleagues studied 15,767 patients with schizophrenia who started treatment with olanzapine, risperidone, quetiapine, or the conventional antipsychotic haloperidol, between 1999 and 2001.

In adjusted analyses, with patients initiating haloperidol serving as the reference group, diabetes risk was increased equally with new use of olanzapine, risperidone, or quetiapine. Each appeared to increase the risk by 60% to 70%, relative to haloperidol, the team reports.

Dr. Lambert stated that “about 2 of every 100 patients on the old drug would be expected to develop diabetes every year, but roughly 3 out of every 100 patients on the new drugs develop diabetes."

The risk of diabetes with the second-generation antipsychotics was higher in patients younger than age 50 years.

"When deciding whether to take one of these new antipsychotic drugs (e.g., olanzapine, risperidone, and quetiapine)," Dr. Lambert commented, "doctors and patients need to consider the risk of developing diabetes. Older drugs (e.g., haloperidol, perphenazine) may be equally effective without the increased risk of diabetes, although all antipsychotic drugs have side effects and risks of their own."

He said it’s also important to note that the current study did not investigate diabetes risk associated with aripirazole and ziprasidone — the newest drugs in this class.

Am J Epidemiol 2006;164:672-681.

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