Differential Effects of Risperidone, Olanzapine, Clozapine, and Conventional Antipsychotics on Type 2 Diabetes: Findings From a Large Health Plan Database
J Clin Psychiatry 2002;63(10):920-930
© Copyright 2015 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Background: Case series suggest that some
antipsychotics may induce or exacerbate type 2 diabetes. This
study measured the association of antipsychotic treatments with
diabetes at a population level.
Method: Claims data for psychosis patients
(ICD-CM-9 290.xx-299.xx) within health plans encompassing 2.5
million individuals were analyzed. Patients reporting preexisting
type 2 diabetes up to 8 months prior to observation were
excluded. The frequency of newly reported type 2 diabetes in
untreated patients and among patients treated with antipsychotics
from 5 categories (risperidone, olanzapine, clozapine, and
high-potency and low-potency conventionals) was compared.
Logistic regression models compared the odds of diabetes based on
exposure to each of the antipsychotic categories.
Results: Based on 12 months of exposure, the
odds of type 2 diabetes for risperidone-treated patients (odds
ratio = 0.88, 95% CI = 0.372 to 2.070) was not significantly
different from that for untreated patients, whereas patients
receiving other antipsychotics had a significantly greater risk
of diabetes than untreated patients (p < .05): olanzapine,
3.10 (95% CI = 1.620 to 5.934); clozapine, 7.44 (95% CI = 0.603
to 34.751); high-potency conventionals, 2.13 (95% CI = 1.097 to
4.134); and low-potency conventionals, 3.46 (95% CI = 1.522 to
7.785). Older age and greater use of non-antipsychotic
psychotropic medications also contributed to risk of type 2
diabetes. Olanzapine also showed significantly higher (p <
.01) odds of diabetes associated with increasing dose.
Conclusion: Consistent with previously published
literature, these data suggest that olanzapine, clozapine, and
some conventional antipsychotics appear to increase the risk of
acquiring or exacerbating type 2 diabetes and that the effect may
vary by drug. In contrast to these agents, risperidone was not
associated with an increased risk of type 2 diabetes.