Any drug can have a side-effect, and side-effects can be serious. An increasing number of adults and children in the United States are being prescribed antipsychotic medications. A new study has found that these drugs can significantly increase the risk of type 2 diabetes in children. The study appears on August 21 in the journal JAMA Psychiatry; it was conducted by researchers at Vanderbilt University School of Medicine (Nashville, Tennessee) and Columbia University College of Physicians and Surgeons (New York, New York)
The researchers note that a number of studies have concluded that adults who take antipsychotic medications, including risperidone (Risperdal) and olanzapine (Zyprexa) have an increased risk of developing type 2 diabetes. However, less is known about the link between these drugs and diabetes in children. They note that studies of other psychiatric medicines, such as antidepressants, have found that children can have different reactions to the same drugs than adults. Thus, the increased prescribing of antipsychotics for children and youth has heightened concerns that this practice increases the risk of type 2 diabetes mellitus.
The investigators conducted a study to compare the risk of type 2 diabetes in children and youth 6 to 24 years of age who were prescribed antipsychotic drugs and compared them to controls who took another type of psychiatric medication.
The study group comprised enrollees in the Tennessee Medicaid program. Of that group, 28,858 were recently prescribed antipsychotic drugs; they were matched with and 14,429 controls. The study excluded patients who previously received a diagnosis of diabetes, schizophrenia, or some other condition for which antipsychotics are the only generally recognized therapy.
The main outcome measurements were newly diagnosed diabetes during follow-up, as identified from diagnoses and diabetes medication prescriptions. The researchers found that users of antipsychotics had a three-fold increased risk for type 2 diabetes, which became apparent within the first year of follow-up. The risk increased with cumulative dose during follow-up. The risk remained elevated for up to one year following discontinuation of antipsychotic use (HR = 2.57 [95% CI = 1.34-4.91]). When the study group was restricted to children 6 to 17 years of age, antipsychotic users had more than a three-fold increased risk of type 2 diabetes, and the risk increased significantly with increasing cumulative dose. The risk was increased for use restricted to atypical antipsychotics or to risperidone.
The authors concluded that children and youth prescribed antipsychotics had an increased risk of type 2 diabetes that increased with cumulative dose.
Take home message:
This study underlines the need to weigh risks and benefits for any medication. Alternatives to antipsychotic medications for children should be considered, particularly for milder cases.