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.
Lambert
Michael T
MT
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
Copeland
Laurel A
LA
Sampson
Nancy
N
Duffy
Sonia A
SA
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