Safe Antipsychotics In Diabetes
Antipsychotics and diabetes can be a dangerous combination because antipsychotics often lead to weight gain and hyperglycemia (high blood sugar). This can make someones diabetes treatment less effective, with blood glucose levels becoming increasingly difficult to control. Individuals with schizophrenia exposed to second-generation antipsychotics (SGA) have an increased risk for diabetes, with aripiprazole purportedly a safer drug.
In most reported cases of hyperglycemia or diabetes associated with antipsychotics, the antipsychotic (usually clozapine or olanzapine) was either stopped completely or substituted with another antipsychotic. Psychotropic medication may be associated with adverse effects, including among people with diabetes. We conducted a systematic review of observational studies investigating the association between antidepressant or antipsychotic drug prescribing and type 2 diabetes outcomes.
Metabolic syndrome is characterized by elevated lipid profile, hypertension, hyperglycemia, and obesity (especially abdominal weight gain). Antipsychotic agents with greatest risk are Clozapine, Olanzapine, and Quetiapine. Aripiprazole, Asenapine, Lurasidone, and Ziprasidone have least risk.
Find out what antipsychotics are safe for diabetics, with lower risks for metabolic side effects like hyperglycemia. Learn about low, intermediate, and high-risk drugs. Whether antipsychotics play a role in diabetes seems to depend partially on the drug used.
The risk among the second-generation drugs seems to be highest for ziprasidone and sertindole and lowest for amisulpride, quetiapine, and aripiprazole. In adults, antipsychotics have been linked to weight gain and insulin resistance, and previous studies have found adults taking these drugs have a 2-3-fold greater risk of developing type 2 diabetes. Individuals with schizophrenia exposed to second-generation antipsychotics (SGA) have an increased risk for diabetes, with aripiprazole purportedly a safer drug.
Less is known about the drugs' mortality risk or whether serious mental illness (SMI) diagnosis or race/ethnicity modify these effects. Based on best practice, members prescribed an antipsychotic should be administered a glucose test or an HbA1c test at least once a year to screen for diabetes. If screening indicates the member is diabetic, the member should be monitored for diabetes.
