Children and adolescents administered antipsychotic medications for the treatment of mood disorders (including bipolar disorder), attention-deficit/hyperactivity disorder and conduct disorders are three times more likely to develop type 2 diabetes compared with controls, according to a recent study.
“The excess risks occurred within the first year of an antipsychotic use, increase with cumulative antipsychotic dose, and was present for children 6 to 17 years of age. The increased risk persisted for up to 1 year following cessation of antipsychotic use,” William V. Bobo, MD, MPH, from the department of psychiatry at Vanderbilt University School of Medicine in Nashville, TN, and colleagues wrote.
The study included 28,858 children and youth (mean age, 14.5 years; 56% boys) who were recently administered antipsychotic therapy, according to researchers. Matched controls (n=14,429) were administered a controlled psychotropic drug.
According to researchers, the most commonly prescribed individual antipsychotic drug was risperdone (Risperdal, Janssen; n=10,718; 37%).
Those administered antipsychotics had a three-fold increased risk for type 2 diabetes (HR=3.03; 95% CI, 1.73-5.32), according to data. This increase was evident as early as the first year of follow-up (HR=2.49; 95% CI, 1.27-4.88), according to researchers. The increased risk continued as the cumulative dose increased to more than 5 grams (HR=2.13; 95% CI, 1.06-4.27); 5 grams to 99 grams (HR=3.42; 95% CI, 1.88-6.24); and 100 grams or more (HR=5.43; 95% CI, 2.34-12.61), according to data.
Moreover, the three-fold increased risk for type 2 diabetes was observed when researchers restricted the cohort to patients aged 6 to 17 years (HR=3.14; 95% CI, 1.50-6.56). During the 55,984 person-years of follow-up, researchers reported that 21 patients developed type 1 diabetes (3.8 per 10,000 person-years).
“Further study of the pathophysiology of antipsychotic-associated diabetes is needed,” researchers wrote.
Disclosure: Bobo reports research support from Cephalon and served on speaker bureaus for Janssen and Pfizer. Olfson reports support from a research grant to Columbia University from Eli Lilly (end date: June 20, 2010) and one from Bristol-Myers Squibb (end date: January 31, 2010). All other researchers report no relevant financial disclosures.