Posted by ed_uk2010 on November 6, 2010, at 16:54:29
In reply to antipsychotics and diabetes, posted by maya3 on November 6, 2010, at 11:39:30
> Hi,
> Does anyone know the mechanism through which APs can bring about diabetes and related disorders?Substantial weight gain can be a causative factor in many cases, but it is not the only mechanism. Antipsychotics can induce a variety of metabolic disturbances. Amongst other things, they often reduce 'glucose tolerance', perhaps by creating a degree of insulin resistance. I think it's fair to say that antipsychotics are drugs which should only be prescribed when they are clearly necessary. No one should be taking APs for non-serious psychiatric problems.
In elderly patients with dementia, the risk of death is elevated by the use of antipsychotics. Over the course of a typical 10-week controlled trial in dementia patients, the rate of death in drug-treated patients was about 4.5%, compared to a rate of about 2.6% in the placebo group. Most deaths were cardiovascular or due to pneumonia (possibly aspiration?).
To what extent antipsychotics affect mortality in young patients with psychiatric illness is not known. Clearly, cardiovascular risk factors need to be monitored and controlled eg. diabetes, BP, weight, smoking, lipids etc. Many patients require additional medication eg. statins, antihypertensives, Xenical, Glucophage.
poster:ed_uk2010
thread:968788
URL: http://www.dr-bob.org/babble/20101030/msgs/968843.html