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A prospective study of glycaemic status in anti-psychotic-treated patients

Lookup NU author(s): Dr Paul Mackin, Helen Watkinson, Emeritus Professor Nicol Ferrier

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Abstract

Anti-psychotic drugs, particularly the second generation, or 'atypical' agents, have been implicated in the development of metabolic dysfunction such as diabetes mellitus. There is a paucity of longitudinal data on the natural history of glucose homeostasis in anti-psychotic-treated patients, and there are no universally accepted strategies for managing worsening glycaemic control in this population. Notwithstanding, several guidelines recommend switching to a 'lower risk' agent if patients develop worsening glycaemic control during anti-psychotic treatment. We prospectively followed a cohort of 106 anti-psychotic-treated patients from across the diagnostic spectrum, and investigated changes in glycaemic status. Between baseline and follow-up assessment (mean follow-up time, 599.3 [SD ± 235.4] days glycaemic status was unchanged in 78 (86.7%) patients; 5 (5.6%) reverted from impaired fasting glucose (IFG) to normoglycaemia in the absence of any pharmacological or lifestyle intervention and all were taking a 'high risk' drug (clozapine or olanzapine). These preliminary data suggest that progression to overt diabetes mellitus is not inevitable in patients who develop IFG during anti-psychotic treatment. Switching to another agent simply on the basis of the development of IFG may not offer any advantage, especially if the mental state is stable. © 2008 British Association for Psychopharmacology.


Publication metadata

Author(s): Mackin P, Bishop D, Watkinson HM, Ferrier IN

Publication type: Article

Publication status: Published

Journal: Journal of Psychopharmacology

Year: 2008

Volume: 22

Issue: 5

Pages: 563-566

ISSN (print): 0269-8811

ISSN (electronic): 1461-7285

Publisher: Sage Publications Ltd.

URL: http://dx.doi.org/10.1177/0269881107081532

DOI: 10.1177/0269881107081532


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