CONTEXT: Understanding the association between use of antipsychotics and onset of diabetes. OBJECTIVE: To compare the rates of new-onset diabetes mellitus (DM) between patients treated for schizophrenia with atypical or conventional antipsychotics. DESIGN: Retrospective analysis of medical and pharmacy claims data. SETTING: 61 US health plans. PATIENTS: Patients with schizophrenia who were treated with atypical or conventional antipsychotics between September 1996 and June 2001 and were enrolled for 12 or more months before and 3 or more months after therapy initiation. MAIN OUTCOME MEASURES: New-onset DM was defined based on 2 or more claims with a diabetes diagnosis or initiation of antidiabetic therapy during follow-up. Rates of DM were compared between patients receiving atypical and conventional antipsychotics, and among 4 subgroups of patients receiving atypical antipsychotics (olanzapine, clozapine, risperidone, quetiapine). Statistical analyses employed logistic regression and Cox proportional hazards models. RESULTS: Patients treated with atypical antipsychotics (N = 1826) were younger, had a lower rate of diagnosed hypertension, and longer duration of therapy than those receiving conventional antipsychotics (N = 617). The crude incidence of DM did not differ (2.46% vs 2.76% for atypical antipsychotics and conventional antipsychotics, P =.525). In Cox proportional hazards models, patients treated with atypical antipsychotics had a statistically significant, moderately increased risk of DM relative to conventional antipsychotics (hazard ratio [HR] = 1.17, 95% confidence interval [CI] = 1.06, 1.30); no significant differences in risk were observed when atypical antipsychotic cohorts were compared. In logistic regression models, no significant differences in DM risk were observed. CONCLUSIONS: Patients with schizophrenia treated with atypical antipsychotics had a moderately increased risk of DM relative to those treated with conventional antipsychotics, as measured by Cox proportional hazards models; such risk was not significantly different among patients treated with individual atypical medications.
CONTEXT: Understanding the association between use of antipsychotics and onset of diabetes. OBJECTIVE: To compare the rates of new-onset diabetes mellitus (DM) between patients treated for schizophrenia with atypical or conventional antipsychotics. DESIGN: Retrospective analysis of medical and pharmacy claims data. SETTING: 61 US health plans. PATIENTS: Patients with schizophrenia who were treated with atypical or conventional antipsychotics between September 1996 and June 2001 and were enrolled for 12 or more months before and 3 or more months after therapy initiation. MAIN OUTCOME MEASURES: New-onset DM was defined based on 2 or more claims with a diabetes diagnosis or initiation of antidiabetic therapy during follow-up. Rates of DM were compared between patients receiving atypical and conventional antipsychotics, and among 4 subgroups of patients receiving atypical antipsychotics (olanzapine, clozapine, risperidone, quetiapine). Statistical analyses employed logistic regression and Cox proportional hazards models. RESULTS:Patients treated with atypical antipsychotics (N = 1826) were younger, had a lower rate of diagnosed hypertension, and longer duration of therapy than those receiving conventional antipsychotics (N = 617). The crude incidence of DM did not differ (2.46% vs 2.76% for atypical antipsychotics and conventional antipsychotics, P =.525). In Cox proportional hazards models, patients treated with atypical antipsychotics had a statistically significant, moderately increased risk of DM relative to conventional antipsychotics (hazard ratio [HR] = 1.17, 95% confidence interval [CI] = 1.06, 1.30); no significant differences in risk were observed when atypical antipsychotic cohorts were compared. In logistic regression models, no significant differences in DM risk were observed. CONCLUSIONS:Patients with schizophrenia treated with atypical antipsychotics had a moderately increased risk of DM relative to those treated with conventional antipsychotics, as measured by Cox proportional hazards models; such risk was not significantly different among patients treated with individual atypical medications.
Authors: D C Henderson; E Cagliero; C Gray; R A Nasrallah; D L Hayden; D A Schoenfeld; D C Goff Journal: Am J Psychiatry Date: 2000-06 Impact factor: 18.112
Authors: Frank D Gianfrancesco; Amy L Grogg; Ramy A Mahmoud; Ruey-hua Wang; Henry A Nasrallah Journal: J Clin Psychiatry Date: 2002-10 Impact factor: 4.384
Authors: M I Harris; K M Flegal; C C Cowie; M S Eberhardt; D E Goldstein; R R Little; H M Wiedmeyer; D D Byrd-Holt Journal: Diabetes Care Date: 1998-04 Impact factor: 19.112
Authors: D A Wirshing; W C Wirshing; L Kysar; M A Berisford; D Goldstein; J Pashdag; J Mintz; S R Marder Journal: J Clin Psychiatry Date: 1999-06 Impact factor: 4.384
Authors: Michael J Sernyak; Douglas L Leslie; Renato D Alarcon; Miklos F Losonczy; Robert Rosenheck Journal: Am J Psychiatry Date: 2002-04 Impact factor: 18.112
Authors: Jess G Fiedorowicz; David A Solomon; Jean Endicott; Andrew C Leon; Chunshan Li; John P Rice; William H Coryell Journal: Psychosom Med Date: 2009-06-26 Impact factor: 4.312
Authors: Megan C Del Valle; Antony D Loebel; Stephen Murray; Ruoyong Yang; David J Harrison; Brian J Cuffel Journal: Prim Care Companion J Clin Psychiatry Date: 2006
Authors: Jess G Fiedorowicz; Del D Miller; Jeffrey R Bishop; Chadi A Calarge; Vicki L Ellingrod; William G Haynes Journal: Curr Psychiatry Rev Date: 2012-02-01
Authors: Vicki L Ellingrod; Del D Miller; Stephan F Taylor; Jessica Moline; Timothy Holman; Jane Kerr Journal: Schizophr Res Date: 2007-10-31 Impact factor: 4.939
Authors: Jess G Fiedorowicz; Narasimha M Palagummi; Valerie L Forman-Hoffman; Del D Miller; William G Haynes Journal: Ann Clin Psychiatry Date: 2008 Jul-Sep Impact factor: 1.567