Second-generation antipsychotics linked to diabetes in pediatric, adolescent patients

  • June 11, 2012

PHILADELPHIA — Researchers reported an independent association between the use of some second-generation antipsychotic agents and increased risk for type 2 diabetes among children and adolescents.

More than 4,100 patients aged 17 years and younger were identified through the South Carolina State Medicaid Program. All had a new prescription for aripiprazole (Abilify, Bristol-Myers Squibb and Otsuka), ziprasidone (Geodon, Pfizer), quetiapine (Seroquel, AstraZeneca), risperidone (Risperdal, Janssen Pharmaceuticals) or olanzapine (Zyprexa, Eli Lilly and Company) between 1996 and 2006. Baseline was defined as the 24-month period of “service encounters” prior to second-generation antipsychotic (SGA) treatment.

Patients were a mean age of 11 years. More than 4% developed new-onset type 2 diabetes during the study.

According to Cox proportional hazard analysis, including time-dependent covariates, there was a higher risk for type 2 diabetes among girls (HR=1.78; 95% CI, 1.30-2.44); black patients (HR=1.52; 95% CI, 1.07-1.25); overweight/obese patients (HR=4.19; 95% CI, 2.87-6.11); those with dyslipidemia (HR=3.33; 95% CI, 1.76-6.30); those using aripiprazole (HR=2.92; 95% CI, 1.08-7.90) or ziprasidone (HR=3.56; 95% CI, 1.61-7.89) vs. no SGA use; and those using mood stabilizers (HR=1.64; 95% CI, 1.13-2.37) vs. no use.

There was a higher causal association among overweight/obese patients (RR=5.59; 95% CI, 2.71-11.51) and those who used ziprasidone (RR=5.12; 95% CI, 1.15-22.70), according to a multivariable marginal structural model.

Based on these data, Avnish Tripathi, MD, MPH, and colleagues at the University of South Carolina said there is a need for increased awareness regarding the use of these agents in pediatric patients, especially those with multiple risk factors for diabetes. – by Stacey L. Fisher

For more information:

Tripathi A. Abstract #17-OR.  Presented at: American Diabetes Association 72nd Scientific Sessions; June 8-12, 2012; Philadelphia.

Disclosure: Dr. Tripathi receives research support from the American Heart Association.

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