New data from the Vermont Department of Mental Health appear to square with studies elsewhere linking several drugs used to treat mental illnesses to a higher risk for diabetes.
The Department of Mental Health looked at adult Medicaid recipients who were getting drugs known as atypical antipsychotic medications in 2005 and found them 60 percent more likely than those not getting the drugs to have diabetes.
John Pandiani, mental health research and statistics chief with the department, said its analysis did not discern whether any of the patients were being treated for diabetes before beginning to take antipsychotic medications.
"We definitely plan on pursuing these different questions that are raised here," Pandiani said.
The department's review included drugs sold under the brand names Abilify, Clozaril, Geodon, Risperdal and Zyprexa, medications used to treat schizophrenia and other serious mental disorders.
In fiscal year 2005 — the 12-month period ending June 30 of that year — 67,395 adults aged 18-64 were enrolled in Vermont's Medicaid system. Of those, 5,445 got prescriptions for one of the antipsychotic drugs and 547 of those patients — a bit more than 10 percent — also had diabetes, the department's report said.
The disparity was much higher among young adults — among 18-to-34-year-olds, those on the antipsychotic drugs were more than twice as likely to have diabetes as those not on the drugs.
The disparity in occurrence of diabetes between those getting the drugs and those not receiving them narrowed with age: Adults aged 35-49 were almost 80 percent more likely to receive diabetes services if they were on one of the antipsychotic drugs; that gap dropped to 3 percent for 50-64-year-olds, an age group in which diabetes prevalence grows in the general population.
Dr. Sandra Steingard, medical director of the Burlington-based Howard Center Mental Health and Substance Abuse Services, said the Vermont results closely track those in other studies.
She said the link between the atypical antipsychotic medications, weight gain and diabetes was well documented. "This has been a big issue in psychiatry," Steingard said. "We've been aware of this problem for quite a while."
The federal Food and Drug Administration required manufacturers of the five drugs included in the state review, plus another atypical antipsychotic, Seroquel, to revise the labels for the medications in 2004 to include warnings about diabetes and related conditions.
Steingard said there is uncertainty about the specific mechanism linking the drugs with diabetes. The drugs often cause weight gain, she said, and obesity is a risk factor for diabetes.
A letter sent by drug maker Eli Lilly to doctors under its agreement with the FDA said the search for a link between its drug Zyprexa and diabetes was "complicated by the possibility of an increased background risk of diabetes" in patients with schizophrenia, as well as the growing incidence of diabetes in the general population.
Steingard said the research she has seen indicates it is "not clear whether the risk for diabetes is due to the weight gain or whether there's some direct effect from the drug."
The data that have come to light to date, though, give her pause, Steingard said.
"We should always be cautious in using these medications," she said. "Diabetes is just one of the concerns that we have. These drugs have many limitations and we should use them as little as possible and at the lowest doses possible."
1 comments:
I'm not surprised by this. One of my friend was told he had developed diebetes recently - I bet this is why! Thanks for the info.
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