Antipsychotic medication information, diabetes side effects, influence on blood sugar levels, safety
Antipsychotics are pharmaceutical drugs used to treat certain mental disorders but they have side effects which include diabetes.
Effect on blood sugar and
diabetes
The prevalence of Diabetes Mellitus is becoming a serious public health problem.
The use of atypical antipsychotics has been associated with disruption of the
glucose metabolism and therefore with causing diabetes. The binding of various
essential receptors or transporters in essential body tissues, adipose tissue,
pancreatic tissue and liver and skeletal muscle tissue can cause disruption of
the glucose metabolism. Clozapine and olanzapine cause weight gain and diabetes
mellitus, whereas aripiprazole and ziprasidone have much less disruptive
clinical profiles. The most significant risk factor for adiposity seems to be
strong blocking of histaminergic receptors. An agonistic activity on
serotonergic-1a receptors, with a very low affinity for muscarinergic-3
receptors, might protect against the development of diabetes.
Increased risk for disease,
metabolic syndrome
Metabolic syndrome and other cardiovascular risk factors are highly prevalent in
people with schizophrenia. Patients are at risk for premature mortality and
overall have limited access to physical health care. In part these
cardio-metabolic risk factors are attributable to unhealthy lifestyle, including
poor diet and sedentary behaviour. But over recent years it has become apparent
that antipsychotic agents can have a negative impact on some of the modifiable
risk factors.
Metabolic considerations in the use of antipsychotic
medications: a review of recent evidence.
J Clin Psychiatry. 2007;68 Suppl 1:20-7. Newcomer JW. From the Departments
of Psychiatry, Psychology, and Medicine, Washington University School of
Medicine, St. Louis, Mo.
Compared with the general population, persons with schizophrenia have up to a
20% shorter lifespan, with cardiovascular disease as the leading cause of death.
In addition, persons with schizophrenia have increased prevalence of the
metabolic syndrome (obesity, insulin resistance, dyslipidemia, impaired glucose
tolerance, and hypertension), increased prevalence of risk factors such as
smoking, poverty, and poor nutrition, and reduced access to medical care.
Results from the recent Clinical Antipsychotic Trials of Intervention
Effectiveness (CATIE) provide further evidence of the metabolic risk associated
with different atypical antipsychotic medications. Based on this study and a
growing number of other randomized clinical trials, clozapine and olanzapine
treatment can produce substantial mean changes in weight and an increased risk
of associated metabolic disturbances. Risperidone and quetiapine treatment can
produce intermediate changes in mean weight in comparison to treatment with
other atypical antipsychotic medications, with discrepant results with respect
to metabolic risk. Aripiprazole and ziprasidone treatment induced the lowest
mean changes in weight gain and had no effect on risk for adverse metabolic
changes, among currently available atypical agents.
Delirium
Antipsychotic medication in the treatment of delirium: a systematic review.
J Clin Psychiatry. 2007 Jan;68(1):11-21.
Department of Psychiatry, Queen's University, Kingston, Ontario, Canada.
Antipsychotic medications are frequently used in the management of delirium,
although there is limited information regarding the safety and efficacy of
antipsychotic medications in treating delirium. The purpose of this study was to
systematically evaluate the evidence for the efficacy and safety of
antipsychotic medications in treating delirium. Study medications included haloperidol, chlorpromazine, olanzapine, risperidone,
and quetiapine. Improvements in delirium severity were reported with all of
these antipsychotic medications. No study included a placebo comparison to
account for spontaneous improvements in delirium. Other methodological
limitations included inadequate blinding, randomization, and handling of
participant withdrawals. The improvements in delirium tended to occur soon after
initiation of treatment, and most of the studies examined used relatively low
doses of antipsychotic medication. Serious adverse events attributable to
antipsychotic medication were uncommon in studies, although side effects were
not evaluated systematically in most studies. To date, there are no
published double-blind, randomized, placebo-controlled trials to establish the
efficacy or safety of any antipsychotic medication in the management of
delirium. There is limited evidence from uncontrolled studies that supports the
use of low-dose, short-term treatment of delirium with some antipsychotic
medications.
Further study with well-designed clinical trials is required in this area.
Nerve cell damage
Ashwagandha may be helpful in reducing nerve cell
damage and CNS side effects
from antipsychotic meds.