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A prospective study of glycaemicstatus in anti-psychotic-treated patients

School of Neurology, Neurobiology and Psychiatry, Newcastle University, UK.

^* To whom correspondence should be addressed.

	Abstract

Anti-psychotic drugs, particularly the second generation, or 'atypical'agents, have been implicated in the development of metabolic dysfunctionsuch as diabetes mellitus. There is a paucity of longitudinal data on thenatural history of glucose homeostasis in anti-psychotic-treated patients,and there are no universally accepted strategies for managing worseningglycaemic control in this population. Notwithstanding, several guidelinesrecommend switching to a 'lower risk' agent if patients develop worseningglycaemic control during anti-psychotic treatment. We prospectivelyfollowed a cohort of 106 anti-psychotic-treated patients from across thediagnostic 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) tonormoglycaemia in the absence of any pharmacological or lifestyleintervention and all were taking a 'high risk' drug (clozapine orolanzapine). These preliminary data suggest that progression to overtdiabetes mellitus is not inevitable in patients who develop IFG duringanti-psychotic treatment. Switching to another agent simply on the basisof the development of IFG may not offer any advantage, especially if themental state is stable.

Key Words: anti-psychotics, diabetes, impaired fasting glucose, schizophrenia, bipolar disorder, body mass index

First published on January 21, 2008, doi:10.1177/0269881107081532

Journal of Psychopharmacology 2008;22:563.

A more recent version of this article appeared on July 1, 2008


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