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Obesity, Diabetes, and the Metabolic Syndrome: New Challenges in Antipsychotic Drug Therapy

Published online by Cambridge University Press:  07 November 2014

Enrique Caballero
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Abstract

Obesity and diabetes continue to be national health epidemics. Greater than 50% of adults in the United States are overweight, and >17 million people have diabetes—one third of whom are not diagnosed. Diabetes ranks number 1 in direct health care costs of any disease category. Patients who suffer from schizophrenia may be at twice the risk of developing diabetes compared with the general population. Some new antipsychotic agents are among several types of medications that may potentially impair glucose metabolism. For example, studies have shown that people treated with clozapine and olanzapine have developed elevated fasting serum insulin levels, suggestive of insulin resistance. Insulin resistance may be a result of irregularities in the insulin action sequence and it may occur long before overt diabetes. The further study of the effects of medications on glucose metabolism and their mechanisms, therefore, is essential to developing better treatment regimens that minimize insulin resistance and avoid associated health risks such as obesity and diabetes.

Type
Academic Supplement
Information
CNS Spectrums , Volume 8 , supplement S2: Optimizing Treatment for Patients With Schizophrenia: Targeting Positive Outcomes , November 2003 , pp. 19 - 22
Copyright
Copyright © Cambridge University Press 2003

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References

REFERENCES

1.Mokdad, AH, Bowman, BA, Ford, ES, Vinicor, F, Marks, JS, Koplan, JP. The continuing epidemics of obesity and diabetes in the United States. JAMA. 2001;286:1195–2000.CrossRefGoogle ScholarPubMed
2.Moldad, AH, Ford, ES, Bowman, BA, et al.Prevalence of obesity, diabetes, and obesity-related health risk factors. JAMA. 2003;289:76–79.Google Scholar
3.Harris, MI, Flegal, KM, Cowie, CC, et al.Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in US adults. The Third National Health and Nutrition Examination Survey, 1988-1994. Diabetes Care. 1998;21:518–524.CrossRefGoogle ScholarPubMed
4.Marso, SP. Optimizing the diabetic formulary: beyond aspirin and insulin. J Am Coll Cardiol. 2002;40:652–661.CrossRefGoogle ScholarPubMed
5.Merz, CN, Buse, JB, Tuncer, D, Twillman, GB. Physician attitudes and practices and patient awareness of the cardiovascular complications of diabetes. J Am Coll Cardiol. 2002;40:1877–1881.CrossRefGoogle ScholarPubMed
6.Haffner, SM, Lehto, S, Ronnemaa, T, Pyorala, K, Laakso, M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med. 1998;339:229–234.CrossRefGoogle ScholarPubMed
7.Harris, MI, Klein, R, Welborn, TA, Knuiman, MW. Onset of NIDDM occurs at least 4-7 yr before clinical diagnosis. Diabetes Care. 1992;15:815–819.CrossRefGoogle ScholarPubMed
8.Fuller, JH, Shipley, MJ, Rose, G, Jarrett, RJ, Keen, H. Coronary-heart-disease risk and impaired glucose tolerance. The Whitehall study. Lancet. 1980;1:1373–1376.CrossRefGoogle ScholarPubMed
9.Brown, WV. Risk factors for vascular disease in patients with diabetes. Diabetes Obes Metab. 2000;2:S11–S18.CrossRefGoogle ScholarPubMed
10.Reaven, GM. Pathophysiology of insulin resistance in human disease. Physiol Rev. 1995;75:473–486.CrossRefGoogle ScholarPubMed
11.Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP). JAMA. 2001;285:2486–2497.CrossRefGoogle Scholar
12.Ford, ES, Giles, WH, Dietz, WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA. 2002;287:356–359.CrossRefGoogle ScholarPubMed
13.Mukherjee, S, Decina, P, Bocola, V, Saraceni, F, Scapicchio, PL. Diabetes mellitus in schizophrenic patients. Compr Psychiatry. 1996;37:68–73.CrossRefGoogle ScholarPubMed
14.Allison, DB, Fontaine, KR, Heo, M, et al.The distribution of body mass index among individuals with and without schizophrenia. J Clin Psychiatry. 1999a;60:215–220.CrossRefGoogle ScholarPubMed
15.Coodin, S. Body mass index in persons with schizophrenia. Can J Psychiatry. 2001;46:549–555.CrossRefGoogle ScholarPubMed
16.Peschke, E, Peschke, D, Hammer, T, Csernus, V. Influence of melatonin and serotonin on glucose-stimulated insulin release from perifused rat pancreatic islets in vitro. J Pineal Res. 1997;23:156–163.CrossRefGoogle ScholarPubMed
17.Allison, DB, Mentore, JL, Heo, M, et al.Antipsychotic-induced weight gain: a comprehensive research synthesis. Am J Psychiatry. 1999b;156:1686–1696.CrossRefGoogle ScholarPubMed
18.Taylor, DM, McAskill, R. Atypical antipsychotics and weight gain—a systematic review. Acta Psychiatr Scand. 2000;101:416–432.CrossRefGoogle ScholarPubMed
19.Kane, JM, Carson, WH, Saha, AR, et al.Efficacy and safety of aripiprazole and haloperidol versus placebo in patients with schizophrenia and schizoaffective disorder. J Clin Psychiatry. 2002;63:763–771.CrossRefGoogle ScholarPubMed
20.Beasley, CM Jr. Safety of olanzapine. Monograph 15. J Clin Psychiatry. 1997;14:19–21.Google Scholar
21.Weiden, P, Mackell, J. Differing side-effect burdens with newer antipsychotics. Paper presented at: 39th Annual Meeting of the National Institute of Mental Health (NIMH)-sponsored New Clinical Drug Evaluation Unit (NCDEU) Program; June 1-4, 1999; Boca Raton, Fla.Google Scholar
22.Weiden, P, Mackell, J, MacDonell, D. Obesity as a risk factor for antipsychotic noncompliance. Schizophr Res. In press.Google Scholar
23.McIntyre, RS, Mancini, DA, Basile, VS. Mechanisms of antipsychotic-induced weight gain. J Clin Psychiatry. 2001;62(suppl 23):23–29.Google ScholarPubMed
24.Glick, ID, Romano, SJ, Simpson, G, et al. Insulin resistance in olanzapine and ziprasidone treated patients: results of a double-blind, controlled 6-week trial. Poster presented at: 154th Annual Meeting of the American Psychiatric Association; May 7-11, 2001; New Orleans, La.Google Scholar
25.Sernyak, MJ, Leslie, DL, Alarcon, RD, Losonczy, MF, Rosenheck, R. Association of diabetes mellitus with use of atypical neuroleptics in the treatment of schizophrenia. Am J Psychiatry. 2002;159:561–566.CrossRefGoogle ScholarPubMed
26.Koro, CE, Fedder, DO, L'Italien, GJ, et al.Assessment of independent effect of olanzapine and risperidone on risk of diabetes among patients with schizophrenia: population based nested case-control study. BMJ. 2002;325:243.CrossRefGoogle ScholarPubMed