New-onset type-2 diabetes associated with atypical antipsychotic medications.
OBJECTIVE
This study compared the one-year incidence of new-onset type-2 diabetes mellitus (DM) and changes in weight in patients with a variety of psychiatric diagnoses prescribed olanzapine, risperidone, or quetiapine, compared to a reference group receiving haloperidol and no other antipsychotic medication.


METHODS
Data was abstracted from charts of subjects newly initiated and then maintained for one year on olanzapine (n=112), risperidone (n=100), quetiapine (n=100), and haloperidol (n=100). Baseline and one-year DM status, height, and weight were collected, as well as concurrent psychotropic medications, medical and psychiatric comorbidities.


RESULTS
Using a multivariate model, logistic regression identified a significant association between olanzapine (but not other atypical agents) and the development of diabetes compared to haloperidol over the one-year period (odds ratio 8.4, 95% CI 1.8-38.7). Baseline obesity was independently associated with new-onset DM, but only marginally greater weight gain was found among olanzapine users.


CONCLUSIONS
The middle-aged American veterans in this study cohort were highly vulnerable to the diabetogenic effects of olanzapine, but a close correlation with weight change was not found. Patients administered olanzapine should receive careful laboratory monitoring for elevated plasma glucose in addition to weight measurement.
University of Texas Southwestern Medical School at Dallas (UTSWMS), Department of Psychiatry, 5323 Harry Hines Blvd., Dallas, TX 75235-9070, and North Texas Veterans Health Care System, USA. Michael.Lambert2@med.va.gov
Michael T
MT
Lambert
Laurel A
LA
Copeland
Nancy
N
Sampson
Sonia A
SA
Duffy
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects*; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011618:Psychotic Disorders / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D012189:Retrospective Studies; D012306:Risk; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs
D014150:Antipsychotic Agents