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The findings, wrote study author Chris Correll, M.D. (pictured left), a professor of psychiatry and molecular medicine at Hofstra North Shore-LIJ School of Medicine, and colleagues, emphasize the importance of routine and proactive monitoring of cardiovascular risk factors when prescribing antipsychotics to youth.
Previous studies have shown a clear link between antipsychotic treatment and impaired glucose tolerance, insulin resistance, and type II diabetes in adults, but less was known about the type 2 diabetes risk in children and adolescents taking antipsychotics. Correll and colleagues analyzed data from 13 longitudinal studies that reported on incidence of type 2 diabetes in 185,105 youth aged 2 to 24, who were exposed to antipsychotics for at least 3 months.
The study authors found that the type 2 diabetes risk and incidence of type 2 diabetes, respectively, were 2.6-fold and 3.0-fold higher in antipsychotic-exposed youth compared with healthy controls and 2.1-fold and 1.8-fold higher compared with psychiatric controls. A separate analysis of 10 of the studies revealed that type 2 diabetes risk was significantly greater in males compared with females, in youth treated with olanzapine, and in those exposed to antipsychotics over a longer period of time.
“Although the [type 2 diabetes] risk was significantly higher in antipsychotic-exposed youth than in psychiatric controls and healthy controls, the number of actual excess cases was low” during the mean follow-up period of 1.7 years, the study authors noted. “Nevertheless, the clinical importance of these findings is underscored by studies showing increased morbidity and mortality associated with an earlier [type 2 diabetes] onset.”
They concluded, “[A]ntipsychotics should only be used when lower-risk interventions have failed, and differential tolerability profiles should influence the antipsychotic choice, including avoidance of olanzapine.”
For related information, see the Psychiatric News article “Recent Rise in Youth on Antipsychotics Raises Concerns Among Experts.”
(Photo Courtesy of Hofstra North Shore-LIJ School of Medicine)