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Back to Pharmacology Articles
Friday, 21st January 2005
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Patients treated with the atypical anti-psychotic agents clozapine and olanzapine
may be at an increased risk for insulin resistance.
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CHICAGO – Patients treated with the atypical anti-psychotic agents
clozapine and olanzapine may be at an increased risk for insulin
resistance, which is a major risk factor for diabetes mellitus,
according to a study in the January issue of The Archives of General
Psychiatry, one of the JAMA/Archives journals.
"Compared with the general population, life expectancy in patients
with schizophrenia is shorter by as much as 20 percent, attributable to
higher rates of suicide, accidental deaths, and natural causes such as
cardiovascular disease, infectious disease, and endocrine disorders,"
according to background information in the article. "Recently, the newer
'atypical' antipsychotic agents have been linked to several forms of
morbidity, including obesity; hyperlipidemia; type 2 diabetes mellitus;
and diabetic ketoacidosis [a severe complication of diabetes]."
David C. Henderson, M.D., from Massachusetts General Hospital and
Harvard Medical School, Boston, and colleagues, evaluated 36 non-obese
outpatients with schizophrenia or schizoaffective disorder who were
treated with clozapine, olanzapine, or another medication, risperidone.
Participants were given a diet to follow to maintain body weight and
were told to fast for 12 hours prior to undergoing a frequently sampled
intravenous glucose tolerance test.
"Both nonobese clozapine- and olanzapine-treated groups displayed
significant insulin resistance and impairment of glucose effectiveness
compared with risperidone-treated subjects," the researchers found.
In conclusion the authors write: "Psychiatrists and primary care
professionals should be aware that patients treated with clozapine and
olanzapine may be at increased risk for insulin resistance, even if not
obese. Insulin resistance is associated with hyperlipidemia,
hypertension, and cardiovascular disease and over time may increase the
risk for diabetes mellitus in vulnerable individuals. Patients treated
with these agents should be routinely screened, counseled to reduce
risk, and provided early interventions."
Source: Arch Gen Psychiatry. 2005; 62: 19 – 28.
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