Which Antipsychotics are Metabolically Safest?

This study examined the potential association between prescriptions of antipsychotics and antidiabetic medications. All people who purchased antipsychotics in Denmark during 1996 to 2005 were included (N = 345,937) and compared with a random sample of about 30% of the total Danish population (N = 1,426,488). Among the total population, incident diabetes subsequently developed in 50,379 individuals. Compared with unexposed individuals, treatment with first- (relative ratio [RR], 1.53; 95% confidence interval [CI], 1.49-1.56) as well as second-generation (RR, 1.32; 95% CI 1.22-1.42) antipsychotics was associated with increased risk for subsequent incident diabetes. The rate of incident diabetes varied substantially between individual second-generation antipsychotic drugs (olanzapine, risperidone, clozapine compared with unexposed individuals: low-to-moderate RR between 1.17 and 1.57; ziprasidone and sertindole: 2 or more times increased rate ratio; amisulpride, quetiapine, and aripiprazole: no significantly increased RR). For both first- and second-generation antipsychotics, the incidence of diabetes increased with the number of prescriptions. Additionally, the incidence of diabetes increased with the number of combined antipsychotic drugs….

Reported by Leslie Citrome, MD, MPH
Medscape Psychiatry & Mental Health

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