In Schizophrenia, Antipsychotic Use May Raise Diabetes Risk

Patients with schizophrenia who are treated with at least 3 different classes of psychotropic medications have an elevated risk for type 2 diabetes, according to new research.

These findings emerged from the Genetic Overlap between Metabolic and Psychiatric disease (GOMAP) study, which included 1653 patients with schizophrenia. Of these, 611 had type 2 diabetes and 1042 did not.

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Information regarding first- and second-generation antipsychotic use, antidepressants, and stabilizers was collected. Patients were categorized as receiving monotherapy, a combination of 2 drugs, or a combination of at least 3 drugs.

The impact of psychotropic medication, body mass index, and various other factors on type 2 diabetes risk were examined, and crude and adjusted odds ratios (ORs) were calculated via logistic regression to determine associations between demographic factors and psychiatric medications.

Following adjustment, results of the study revealed an increased risk of type 2 diabetes among patients with schizophrenia who used at least 3 different classes of psychiatric drugs (OR 1.81) compared with those who use first-generation antipsychotic therapy alone.

However, this association was not observed for second-generation antipsychotic use or for the use of psychiatric drugs belonging to 2 different classes (OR 1.27) compared with first-generation antipsychotic use.

“We find an increased risk of [type 2 diabetes] in patients with [schizophrenia] who take a combination of at least three different psychotropic medication classes compared to patients whose medication consists only of one or two classes of drugs,” the researchers wrote.

—Christina Vogt

Reference:

Mamakou V, Hackinger S, Zengini E, et al. Combination therapy as a potential risk factor for the development of type 2 diabetes in patients with schizophrenia: the GOMAP study [Published online August 2, 2018]. BMC Psychiatry. https://doi.org/10.1186/s12888-018-1826-4