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Article

Antipsychotic Drugs, Insulin Resistance, Hyperglycemia, and Diabetes Mellitus

Daniel E. Casey, MD; Dan W. Haupt, MD; John W. Newcomer, MD; David C. Henderson, MD; Michael J. Sernyak, MD; Michael Davidson, MD; Jean-Pierre Lindenmayer, MD; Steven V. Manoukian, MD, FACC; Mary Ann Banerji, MD; Harold E. Lebovitz, MD; and Charles H. Hennekens, MD

Published: May 1, 2004

Article Abstract

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A range of evidence spanning case reports and case series, prospective observational studies, retrospective database analyses, and controlled analytic studies including randomized clinical trials suggests that treatment with certain antipsychotic medications, in comparison to no treatment or treatment with alternative antipsychotics, is associated with increased risk of insulin resistance, hyperglycemia, and type 2 diabetes mellitus.78 Interpretation of these studies has been complicated by the fact that abnormalities in glucose regulation were first reported in schizophrenia prior to the introduction of antipsychotic medications, with early reports indicating a pattern of insulin resistance in untreated patients.79,80 Despite failure to control for age, weight, adiposity, ethnicity, or diet in these early studies, the evidence suggests that patients with schizophrenia may have a higher risk of impaired glucose metabolism compared to the general population, with likely contributions from factors such as diet and activity level.


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