Olanzapine, Quetiapine Increase Risk of Gestational Diabetes
Women who continue to take olanzapine or quetiapine during pregnancy are at increased risk of developing gestational diabetes, according to a study published online in The American Journal of Psychiatry.
Because certain antipsychotics have previously been linked with metabolic side effects including weight gain and diabetes in the general population, researchers looked at Medicaid records to ascertain whether a similar link exists between the medications and gestational diabetes.
Among 5 atypical antipsychotics included in the study, quetiapine and olanzapine were the only 2 linked with an increased risk of developing gestational diabetes. Compared to women who discontinued use of the medications during pregnancy, women who continued olanzapine had a 61% increased risk of gestational diabetes, and women who continued taking quetiapine had a 28% increased risk.
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“The risks of gestational diabetes observed during pregnancy are in line with expectations based on the metabolic side effects observed in the general population,” said study senior author Krista F. Huybrechts, MS, PhD, an epidemiologist at Brigham and Women’s Hospital in Boston, Massachusetts. “Certain antipsychotics have different levels of risk of metabolic side effects.”
Continuing to take aripiprazole, ziprasidone, or risperidone during pregnancy was not linked with a heightened risk of gestational diabetes, the study found.
The investigation accounted for several variables, and researchers expressed confidence that the increased risk with olanzapine and quetiapine—which corresponds with an extra 4.4 cases and an extra 1.6 cases of gestational diabetes per 100 women treated, respectively—was not due to overweight or obesity measurements at the start of pregnancy.
“Clinicians must weigh the benefits of staying on a stable regimen against the risks of continuing treatment with a higher-risk atypical antipsychotic during pregnancy,” Dr. Huybrechts advised, “to make an informed decision about the best course of treatment for the patient in question.”
—Jolynn Tumolo
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