Few Changes in Antipsychotic Prescription Seen after Diagnosis of Diabetes

Among patients being treated with antipsychotic medication, including those who were taking the most generation of drugs, a new diagnoses of diabetes did not result in substantial changes in prescription, according to a a study at Yale School of Medicine.

Second generation antipsychiotics, including clozapine, olanzapine, quetiapine, risperidone, zipradisone, and aripiprazole, are as effective in treating schizophrenia as first generation anti-psychotics, but some evidence suggests that these medications are associated with other side effects, such as weight gain and increased risk of diabetes, said first author Douglas Leslie, assistant professor of psychiatry.

Of 56,849 patients who participated in the study of these drugs, 7.3 percent were later diagnosed with diabetes. The number of patients who switched or discontinued antipsychotics were small and were statistically significant only for patients who were taking risperidone before the diagnosis of diabetes, Leslie said.

Leslie and senior author Robert Rosenheck, M.D., professor of psychiatry, also looked at the costs of managing diabetes in patients on these drugs. They found the average cost was $3,104 over the average follow up of 15.7 months, or $6.59 per day.

“The results presented here offer important insight into the consequences of newly diagnosed diabetes among patients who have schizophrenia and take antipsychotics,” Leslie said. “Diabetes does not appear to lead to substantial changes in antipsychotic pharmacotherapy, and the cost implications were negligible, although patients were followed for an average of only 15 months.”

Psychiatric Services Vol. 56: 803-809 (July 2005)

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