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Antipsychotic Medications Increase Diabetes Risk

Antipsychotic medications are a diverse assortment of medications designed to treat psychosis, the collective term for a number of symptoms found in people with schizophrenia and several other mental disorders. Doctors generally divide antipsychotics into two groups: older medications called typical antipsychotics and newer medications called atypical antipsychotics. Recent findings indicate that people who take certain antipsychotic drugs have significantly increased chances of developing the blood glucose disorder called type 2 diabetes. Some of these drugs belong to the typical antipsychotic group, while others belong to the atypical antipsychotic group.

Antipsychotic Basics

Antipsychotics get their name because they counter the effects of psychosis, which include such things as delusional (deeply irrational) thought patterns, hallucinations affecting hearing or vision, an inability to maintain a single train of thought and an inability to fully use spoken language. In addition to appearing in connection with schizophrenia and related conditions such as brief psychotic disorder and schizotypal personality disorder, psychosis can appear in a small number of people affected by bipolar disorder or major depression, or in people with a range of medical conditions unrelated to a mental disorder.

Typical antipsychotic medications have been in use for roughly 60 years, and achieve their effects by making certain alterations in a person’s brain chemistry. Examples of these medications include haloperidol (Haldol), trifluoperazine (Stelazine) and chlorpromazine (Thorazine, Largactil). Atypical antipsychotics entered use in the early 2000s; they also alter brain chemistry, but in partially different ways than typical antipsychotics. Examples of these medications include risperidone (Risperdal), aripiprazole (Abilify), quetiapine (Seroquel), olanzapine (Zyprexa) and clozapine (Clozaril). Atypical medications were introduced into use because, when compared to typical antipsychotics, they generally produce smaller chances for severe side effects such as an involuntary movement disorder called tardive dyskinesia or a loss of muscle control that strongly resembles the symptoms of Parkinson’s disease.

Type 2 Diabetes Basics

People with type 2 diabetes have a harmful buildup of glucose in their bloodstreams caused by a poor reaction to the effects of an internally produced substance called insulin. Normally, the body relies on insulin to get glucose out of the bloodstream and into cells such as liver, muscle, brain and fat cells. When glucose doesn’t leave the blood in sufficient amounts, its continuing presence gradually leads to a decline in the function of several vital body systems, including the cardiovascular (heart and blood vessel) system and the nervous system. Once diagnosed with type 2 diabetes, a person technically has the condition for life, even if he or she successfully keeps blood glucose levels low through the help of lifestyle changes and medication.

Diabetes Risks

Even before antipsychotics entered the market, researchers noted that people diagnosed with schizophrenia have unusually high chances of developing type 2 diabetes. In addition, while atypical antipsychotics lower a person’s risks for Parkinson’s-like symptoms and tardive dyskinesia, they increase a person’s risks for gaining significant amount of weight. This is important because excessive weight gain and the associated onset of obesity play major roles in making the body susceptible to type 2 diabetes.

In a study review published in 2012 in Pharmacy Times, researchers from South University School of Pharmacy examined the diabetes-related risks of taking various types of atypical antipsychotic medications. The authors of this review made several important conclusions. Most critically, they found that almost 80 percent of the people who take atypical antipsychotics experience substantial gains in body weight that increase the chances for developing diabetes. However, not all medications in this group produce equal risks. Specific atypical antipsychotics with the strongest connections to type 2 diabetes include clozapine (Clozaril) and olanzapine (Zyprexa). Atypical antipsychotics with the weakest connections to type 2 diabetes include aripiprazole (Abilify) and ziprasidone (Geodon).

Considerations

Low-potency forms of typical antipsychotic medications also have the ability to increase a person’s chances of developing type 2 diabetes. Since not all of these medications produce weight gain, scientists believe that they may cause harm by directly altering the way the body makes or uses insulin. Interestingly, high-potency forms of typical antipsychotics don’t increase type 2 diabetes risks as much as the low-potency forms. Doctors prescribing antipsychotics to their patients typically try to keep diabetes-related concerns in check by doing such things as screening all potential antipsychotic users for preexisting blood glucose problems, prescribing the safest possible medications, monitoring all patients for blood glucose changes and weight gain, and recommending appropriate activities and dietary changes to control weight gain.

 

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