Antipsychotic medications linked to occurrence of diabetes in children
Research Activities, December 2012, No. 388
The use of second-generation antipsychotics (SGAs) has risen dramatically for children and adolescents. Yet, the majority of prescribing of these drugs is off-label and data on their safety and efficacy for children are limited. Numerous case reports and studies have suggested a link between antipsychotic medications and diabetes in adults. Now a new study has found that children using SGAs had a higher incidence of diabetes than children who were not using any psychotropic medications. However, there was no significant difference in the incidence of diabetes among children using SGAs compared to children using antidepressants.
The researchers had access to the databases of 3 health maintenance organizations enrolling over 700,000 youths 5 to 18 years of age. Of this group, over 9,000 initiated therapy with SGAs between 2001 and 2008. There was a potentially fourfold increased rate of diabetes among children within the first year of initiation of SGA therapy compared to the children who were not using any psychotropic medications.
The researchers suggest that SGAs may affect serotonin 5-HT receptors, resulting in inhibition of insulin release, insulin resistance, or impairment of glucose utilization. Also, previous evidence suggested that youths receiving SGAs experience adverse changes in body composition and metabolic parameters even after short-term therapy. The authors caution that these findings suggest an important drug safety and public health issue that needs to be further evaluated. Their study was supported the by the Agency for Healthcare Research and Quality (HS16955).
See "Antipsychotic medication use among children and risk of diabetes mellitus" by Susan E. Andrade, Sc.D., Joan C. Lo, M.D., Douglas Roblin, Ph.D., and others in Pediatrics 128, pp. 1135-1141, 2011.