Association of diabetes mellitus with use of atypical neuroleptics in the treatment of schizophrenia

Michael J. Sernyak, Douglas L. Leslie, Renato D. Alarcon, Miklos F. Losonczy, Robert Rosenheck

Research output: Contribution to journalArticle

567 Citations (Scopus)

Abstract

Objective: The development of both type I and type II diabetes after initiation of some atypical neuroleptics has been reported, primarily in studies involving small series of patients. This study used administrative data from a large national sample of patients with a diagnosis of schizophrenia to compare the prevalence of diabetes mellitus in patients receiving prescriptions for atypical and typical neuroleptics. Method: All outpatients with schizophrenia treated with typical and atypical neuroleptics over 4 months in 1999 in the Veterans Health Administration of the Department of Veterans Affairs (VA) were included in this study. Patients treated with atypical neuroleptics were those who received prescriptions for clozapine, olanzapine, risperidone, or quetiapine. Patients with a diagnosis of diabetes were also identified by using ICD-9 codes in VA administrative databases. The prevalence of diabetes mellitus across age groups and among patients receiving prescriptions for different atypical neuroleptics was examined with multiple logistic regression. Results: A total of 38,632 patients were included in the study: 15,984 (41.4%) received typical neuroleptics and 22,648 (58.6%) received any atypical neuroleptic (1,207 [5.3%] received clozapine; 10,970 [48.4%], olanzapine; 955 [4.2%], quetiapine; and 9,903 [43.7%], risperidone; 387 patients received prescriptions for more than one atypical neuroleptic). When the effects of age were controlled, patients who received atypical neuroleptics were 9% more likely to have diabetes than those who received typical neuroleptics, and the prevalence of diabetes was significantly increased for patients who received clozapine, olanzapine, and quetiapine, but not risperidone. However, for patients less than 40 years old, all of the atypical neuroleptics were associated with a significantly increased prevalence of diabetes. Conclusions: In this large group of patients with schizophrenia, receipt of a prescription for atypical neuroleptics was significantly associated with diabetes mellitus.

Original languageEnglish (US)
Pages (from-to)561-566
Number of pages6
JournalAmerican Journal of Psychiatry
Volume159
Issue number4
DOIs
StatePublished - Apr 15 2002

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Antipsychotic Agents
Schizophrenia
Diabetes Mellitus
olanzapine
Prescriptions
Risperidone
Clozapine
Therapeutics
International Classification of Diseases
Veterans
Veterans Health
United States Department of Veterans Affairs
Type 2 Diabetes Mellitus
Outpatients
Age Groups
Logistic Models
Databases

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health

Cite this

Sernyak, Michael J. ; Leslie, Douglas L. ; Alarcon, Renato D. ; Losonczy, Miklos F. ; Rosenheck, Robert. / Association of diabetes mellitus with use of atypical neuroleptics in the treatment of schizophrenia. In: American Journal of Psychiatry. 2002 ; Vol. 159, No. 4. pp. 561-566.
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abstract = "Objective: The development of both type I and type II diabetes after initiation of some atypical neuroleptics has been reported, primarily in studies involving small series of patients. This study used administrative data from a large national sample of patients with a diagnosis of schizophrenia to compare the prevalence of diabetes mellitus in patients receiving prescriptions for atypical and typical neuroleptics. Method: All outpatients with schizophrenia treated with typical and atypical neuroleptics over 4 months in 1999 in the Veterans Health Administration of the Department of Veterans Affairs (VA) were included in this study. Patients treated with atypical neuroleptics were those who received prescriptions for clozapine, olanzapine, risperidone, or quetiapine. Patients with a diagnosis of diabetes were also identified by using ICD-9 codes in VA administrative databases. The prevalence of diabetes mellitus across age groups and among patients receiving prescriptions for different atypical neuroleptics was examined with multiple logistic regression. Results: A total of 38,632 patients were included in the study: 15,984 (41.4{\%}) received typical neuroleptics and 22,648 (58.6{\%}) received any atypical neuroleptic (1,207 [5.3{\%}] received clozapine; 10,970 [48.4{\%}], olanzapine; 955 [4.2{\%}], quetiapine; and 9,903 [43.7{\%}], risperidone; 387 patients received prescriptions for more than one atypical neuroleptic). When the effects of age were controlled, patients who received atypical neuroleptics were 9{\%} more likely to have diabetes than those who received typical neuroleptics, and the prevalence of diabetes was significantly increased for patients who received clozapine, olanzapine, and quetiapine, but not risperidone. However, for patients less than 40 years old, all of the atypical neuroleptics were associated with a significantly increased prevalence of diabetes. Conclusions: In this large group of patients with schizophrenia, receipt of a prescription for atypical neuroleptics was significantly associated with diabetes mellitus.",
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Association of diabetes mellitus with use of atypical neuroleptics in the treatment of schizophrenia. / Sernyak, Michael J.; Leslie, Douglas L.; Alarcon, Renato D.; Losonczy, Miklos F.; Rosenheck, Robert.

In: American Journal of Psychiatry, Vol. 159, No. 4, 15.04.2002, p. 561-566.

Research output: Contribution to journalArticle

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AU - Leslie, Douglas L.

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N2 - Objective: The development of both type I and type II diabetes after initiation of some atypical neuroleptics has been reported, primarily in studies involving small series of patients. This study used administrative data from a large national sample of patients with a diagnosis of schizophrenia to compare the prevalence of diabetes mellitus in patients receiving prescriptions for atypical and typical neuroleptics. Method: All outpatients with schizophrenia treated with typical and atypical neuroleptics over 4 months in 1999 in the Veterans Health Administration of the Department of Veterans Affairs (VA) were included in this study. Patients treated with atypical neuroleptics were those who received prescriptions for clozapine, olanzapine, risperidone, or quetiapine. Patients with a diagnosis of diabetes were also identified by using ICD-9 codes in VA administrative databases. The prevalence of diabetes mellitus across age groups and among patients receiving prescriptions for different atypical neuroleptics was examined with multiple logistic regression. Results: A total of 38,632 patients were included in the study: 15,984 (41.4%) received typical neuroleptics and 22,648 (58.6%) received any atypical neuroleptic (1,207 [5.3%] received clozapine; 10,970 [48.4%], olanzapine; 955 [4.2%], quetiapine; and 9,903 [43.7%], risperidone; 387 patients received prescriptions for more than one atypical neuroleptic). When the effects of age were controlled, patients who received atypical neuroleptics were 9% more likely to have diabetes than those who received typical neuroleptics, and the prevalence of diabetes was significantly increased for patients who received clozapine, olanzapine, and quetiapine, but not risperidone. However, for patients less than 40 years old, all of the atypical neuroleptics were associated with a significantly increased prevalence of diabetes. Conclusions: In this large group of patients with schizophrenia, receipt of a prescription for atypical neuroleptics was significantly associated with diabetes mellitus.

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