Atypical antipsychotics associated with an increased risk of diabetes
The prevalence of diabetes has been reported to be 2–3 times higher in people with schizophrenia than in the general population. The reason for this increased prevalence is not well understood, although antipsychotic medication (especially the atypical antipsychotics) is thought to be partly to blame. The first observation of an association between antipsychotics and diabetes occurred over 50 years ago, but renewed interest in this issue has developed over the past decade.
A review of the existing data relating to the comparative risk for diabetes with conventional and atypical antipsychotics in people with schizophrenia was recently published in the British Journal of Psychiatry. The study authors systematically searched various archives of biomedical journals, and included in their analysis 11 studies of differing designs that:
- compared conventional antipsychotics with atypical antipsychotics (that is, clozapine, olanzapine, quetiapine, and risperidone); and
- measured incidence of diabetes as an outcome.
The analysis found that atypical antipsychotics were associated with an increased risk for diabetes compared with conventional antipsychotics. However, methodological limitations were found in nearly all the included studies. These limitations resulted in findings that varied from study to study, and also caused difficulties in comparing and interpreting the findings collectively.
The study authors conclude that, “regardless of type of antipsychotic, screening for diabetes in all people with schizophrenia should be routine.”
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