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August 15, 2005

Antipsychotics & The Risk of Insulin Resistance and Dyslipidemia

Second generation antipsychotics (SGA's) have been studied thoroughly in regard to many health risks. The metabolic effects of SGA's which are also known as atypical antipsychotics, were looked at in this study which was found in the Psychiatric Times. The researchers had three treatment conditions "antipsychotic-naive, pretreated but currently drug free and switchers", and six different atypical antipsychotics. The six medications used were: Abilify, Clozaril, Zyprexa, Seroquel, Risperdal, and Geodon. The study was not randomized, but it has the benefit of being the largest study done on "naive individuals taking novel antipsychotics". This study also looked at the effects that these medications had on children's metabolic effect.

Several factors were measured, including factors such as their weight, fat mass, fasting glucose, and insulin levels. There were several other factors that were measured; these were all looked at in the beginning of the study, after 4 weeks, and after 12 weeks. The study found that "When individual SGAs were considered, increases in glucose reached significance only for risperidone, while changes in insulin and HOMA-IR [HOMA-IR=insulin umol x glucose mmol/22.5] were only significant for olanzapine. Glucose increase was correlated with low baseline glucose levels and male gender (R2=0.48, p<0.0001), while an increase in HOMA-IR was correlated with weight gain and a diagnosis of disruptive behavior disorders (R2=0.21, p<0.0001)" (Kaplan, 2005).

The researchers found that insulin resistance was more common in the young population taking olanzapine (Zyprexa), risperidone (Risperdal) or quetiapine (Seroquel) after 3 months of taking the medications. Weight and glucose level should be routinely monitored by those taking these medications.

Risk of developing dyslipidemia was also looked at; dyslipidemia is a "a condition marked by abnormal concentrations of lipids or lipoproteins in the blood" (Medline Plus Medical Dictionary) (lipids are essentially fats, and lipoproteins are a complex of lipids and proteins). Researchers found that "individual lipid parameters increased significantly from baseline to end point, but 19.2% of youths developed new-onset dyslipidemia, without statistical differences between the medication groups" (Kaplan, 2005).

These findings hold important meaning to those who take atypical antipsychotics, especially children. One's insulin resistance and dyslipidemia should be consistently looked at to insure that one does not develop either of these conditions and so that one does not develop diabetes.

Original Source: Second-Generation Antipsychotics and the Risk of Insulin Resistance, Dyslipidemia in Children. Psychiatric Times Vol.XXII Issue 8. By Arline Kaplan. July 2005.

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