Risk of Diabetes Mellitus Associated with Atypical Antipsychotic Use Among Medicaid Patients with Bipolar Disorder: A Nested Case‐Control Study

  title={Risk of Diabetes Mellitus Associated with Atypical Antipsychotic Use Among Medicaid Patients with Bipolar Disorder: A Nested Case‐Control Study},
  author={Jeff Jianfei Guo and Paul E. Keck and Patricia K Corey-Lisle and Hong Li and Dongming Jiang and Raymond Jang and Gilbert J. L’italien},
  journal={Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy},
  • J. GuoP. Keck G. L’italien
  • Published 1 January 2007
  • Medicine, Psychology
  • Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
Study Objective. To quantify the risk of diabetes mellitus associated with atypical antipsychotics compared with conventional antipsychotics in managed care Medicaid patients with bipolar disorder. 

Association between history of psychosis and cardiovascular disease in bipolar disorder

To determine whether clinical features of bipolar disorder, such as history of psychosis, and cardiovascular disease (CVD) risk factors contribute to a higher risk of CVD among patients withipolar disorder, a large number of patients with bipolar disorder were surveyed.

Risk of myocardial infarction and stroke in bipolar disorder: a systematic review and exploratory meta‐analysis

To review the evidence on and estimate the risk of myocardial infarction and stroke in bipolar disorder, a large number of patients with bipolar disorder have had a heart attack or stroke.

Insulin Resistance in Bipolar Women: Effects of Mood-Stabilizing Drugs

Women with bipolar disorder (BD) may have unique risk factors for insulin resistance (IR). Specific periods in a woman’s reproductive timeline, specifically pregnancy and after the menopause, may repr

The risk of metabolic disorders in patients treated with asenapine or olanzapine: a study conducted on real-world data in Italy and Spain

Asenapine is associated with a lower risk of metabolic adverse effects than olanzapine, demonstrating its improved safety profile, according to a retrospective analysis based on data extracted from the Italian and Spanish Cegedim Strategic Data Longitudinal Patient-Data databases.

The Impact of Cardiometabolic Risk in Patients with Severe Mental Illness: From Evidence to Clinical Management

A final important source of cardiometabolic risk in major mental disorders is treatment itself although before the introduction of the antipsychotic drugs it was acknowledged that patients with schizophrenia and bipolar disorder may be at a higher risk of abnormal glucose metabolism and metabolic disorders compared to general population.

Reaching for wellness in schizophrenia.

Schwere psychische Erkrankungen und Diabetes mellitus Typ-2

Prevalence rates of DM type 2 as well as important individual lifestyle choices and side effects of antipsychotic and antidepressant treatment are reported, which each account for much of the increased risk of this metabolic disease in patients with severe mental illness.

Bipolar Disorder and Weight Gain: A Multifactorial Assessment

A model for nursing assessment will propose methods for modifying risk factors and encouraging healthy lifestyle changes and the goal is to improve this component of quality of life for persons with bipolar disorder.

Primary care issues in patients with mental illness.

Physicians should carefully consider the risks and benefits of second-generation antipsychotic medications, and patient care should be coordinated between primary care physicians and mental health professionals to prevent serious adverse effects.

Treatment of Co-Morbid Mental Illness in Primary Care: How to Minimize Weight Gain, Diabetes, and Metabolic Syndrome

In patients with mental illness and co-morbid diabetes, metabolic syndrome, and obesity, psychiatrist and primary care clinicians should collaborate to establish a plan for healthy lifestyle habits (diet and activity regimen), encourage weight loss, and follow-up regularly using multispecialty teams to improve management.



Antipsychotic exposure and type 2 diabetes among patients with schizophrenia: a matched case‐control study of California Medicaid claims

To examine the risk of developing type 2 diabetes mellitus among people with schizophrenia exposed to atypical antipsychotics (clozapine, olanzapine, quetiapine, risperidone) compared to those

Risperidone‐Associated Diabetes Mellitus: A Pharmacovigilance Study

The objective is to explore the clinical characteristics of hyperglycemia in patients treated with risperidone and to find out whether these characteristics can be improved with further treatment.

Diabetes as a result of atypical anti‐psychotic drugs – a report of three cases

  • V. RigalleauB. Gatta H. Gin
  • Medicine, Psychology
    Diabetic medicine : a journal of the British Diabetic Association
  • 2000
Aims  Atypical anti‐psychotic drugs (APDs) are widely used in psychotic disorders refractory to conventional neuroleptic agents.

Treatment of bipolar disorder∗

The current status of the management of bipolar disorder (manic‐depressive illness) is reviewed with a focus on hospital admissions and treatment regimens.

Incidence of New-Onset Diabetes Mellitus Among Patients Receiving Atypical Neuroleptics in the Treatment of Mental Illness: Evidence From a Privately Insured Population

Diabetes risk was significantly lower among males receiving risperidone or quetiapine, while diabetes risk among females did not differ significantly from first-generation antipsychotics for any atypical examined, substantially different from other reports.

Clozapine use in patients with schizophrenia and the risk of diabetes, hyperlipidemia, and hypertension: a claims-based approach.

Data suggest that clozapine may not be an independent cause of diabetes or hyperlipidemia, but instead acts as an effect modifier in susceptible populations by increasing weight or affecting insulin secretion and resistance.

Hyperglycemia associated with the use of atypical antipsychotics.

These studies indicate that hyperglycemia is not dose dependent, is reversible on cessation of treatment with clozapine or olanzapine, and reappears on reintroduction of these therapies.

Incident diabetes associated with antipsychotic use in the United Kingdom general practice research database.

This study showed an increased risk of incident diabetes among current users of atypical and conventional antipsychotic medications, independent of other established risk factors.

Assessment of independent effect of olanzapine and risperidone on risk of diabetes among patients with schizophrenia: population based nested case-control study

Patients taking olanzapine are associated with a clinically important and significant increased risk of diabetes and non-users of antipsychotics are not affected.

Incidence of newly diagnosed diabetes attributable to atypical antipsychotic medications.

The proportion of patients with schizophrenia with a stable regimen of antipsychotic monotherapy who developed diabetes or were hospitalized for ketoacidosis was determined and clozapine and olanzapine have greater diabetes risk, but the attributable risk of diabetes mellitus with atypical antipsychotics is small.