• Abstract
  • References
  • Cite This Article as
  • Corresponding Author

Introduction:- People with schizophrenia are at increased risk of developing metabolic disturbances. This risk may be further exacerbated by the use of antipsychotic agents. Research is still ongoing to determine the metabolic impact of antipsychotics on glucose regulation. In this case report we review some of the possible mechanisms of action of antipsychotic medication on glucose regulation. Case presentation:- We present the case of a 50-year-old man diagnosed with paranoid schizophrenia who developed type 2 diabetes mellitus whilst on treatment with second generation antipsychotics (SGA). His diabetes was controlled by a combination of antidiabetic drugs that were associated with his psychotropic treatment. Due to deterioration in his mental state, the patient was admitted on two occasions to a psychiatric unit during which his prescribed medication (olanzapine and risperidone) was discontinued and changed to aripiprazole. On both occasions, the patient suffered hypoglycaemic episodes and his antidiabetic treatment had to be adjusted accordingly. The patient did not require any antidiabetic treatment whilst on aripiprazole during the follow up period. Conclusion:- Clinicians face regular dilemmas in trying to find the right balance between achieving control over a patient\\\\\\\\\\\\\\\'s mental illness and reducing any adverse effects associated with the prescribed medication. In patients receiving concomitant antidiabetic therapy, caution should be exercised when changing from one SGA to another. Whilst more longitudinal data are required, a trial of alternative SGAs, including aripiprazole in those developing type 2 diabetes and impaired glucose tolerance may be a worthwhile therapeutic option.

  1. American Diabetes Association, American Psychiatric Association, APA, American Association of Clinical Endocrinologists, North American Association for the Study of Obesity: Consensus development conference on antipsychotic drugs and obesity and diabetes. Obes Res. 2004, 12: 362-368.View ArticleGoogle Scholar
  2. Geddes J, Freemantle N, Harrison P, Bebbington P: Atypical antipsychotics in the treatment of schizophrenia: systematic overview and meta-regression analysis. Br Med J. 2000, 321: 1371-1376. 10.1136/bmj.321.7273.1371.View ArticleGoogle Scholar
  3. Newcomer JW: Metabolic risk during antipsychotic treatment. Clin Ther. 2004, 26: 1936-1946. 10.1016/j.clinthera.2004.12.003.View ArticlePubMedGoogle Scholar
  4. Sermyak MJ, Gulanski B, Rosenheck R: Undiagnosed hyperglycemia in patients treated with atypical antipsychotics. J Clin Psychiatry. 2005, 66 (11): 1463-1467.View ArticleGoogle Scholar
  5. Gough S, Peveler R: Diabetes and its prevention: pragmatic solutions for people with schizophrenia. Br J Psychiatry. 2004, 184 (Suppl 47): 106-111. 10.1192/bjp.184.47.s106.View ArticleGoogle Scholar
  6. Newcomer JW: Abnormalities of glucose metabolism associated with atypical antipsychotic drugs. J Clin Psychiatry. 2004, 65 (Suppl 18): 36-46.PubMedGoogle Scholar
  7. Newcomer JW: Second generation (atypical) antipsychotics and metabolic effects: a comprehensive literature review. CNS Drugs. 2005, 19 (Suppl 1): 1-93.PubMedGoogle Scholar
  8. Duncan E, Dunlop B, Boshoven W, Woolson S: Relative risk of glucose elevation during antipsychotic exposure in Veterans Administration Population. Int Clin Psychopharmacol. 2007, 22: 1-11. 10.1097/01.yic.0000285500.87524.5a.PubMedGoogle Scholar
  9. Houseknecht K, Robertson A, Zavadoski W, Gibbs EM, Johnson DE, Rollema H: Acute effects of atypical antipsychotics on whole body insulin resistance in rats: implications for adverse metabolic effects. Neuropsychopharmacology. 2007, 32: 289-297. 10.1038/sj.npp.1301209.View ArticlePubMedGoogle Scholar
  10. De Hert M, Hanssens L, Van Winkel R, Wampers M, Van Eyck D, Sheen A, Peuskens J: A Case Series: evaluation of the metabolic safety of aripiprazole. Schizophr Bull. 2007, 33: 823-830. 10.1093/schbul/sbl037.View ArticlePubMedGoogle Scholar
  11. Reddymasu S, Bahta E, Levine S, Manas K, Slay L: Elevated lipase and diabetic ketoacidosis associated with aripiprazole. JOP. 2006, 7: 303-305.PubMedGoogle Scholar
  12. Church CO, Stevens DL, Fugate SE: Diabetic ketoacidosis associated with aripiprazole. Diabet Med. 2005, 22: 1440-1443. 10.1111/j.1464-5491.2005.01628.x.View ArticlePubMedGoogle Scholar
  13. Melkersson KI, Dahl ML, Hulting AL: Guidelines for prevention and treatment of adverse effects of antipsychotic drugs on glucose-insulin homeostasis metabolism. Psychopharmacology. 2004, 175: 1-6. 10.1007/s00213-004-1922-7.View ArticlePubMedGoogle Scholar
  14. De Hert M, Hansens L, van Winkel R, Wampers M, Van Eyck D, Sheen A, Peuskens J: Reversibility of antipsychotic treatment-related diabetes in patients with schizophrenia; a case series of switching to aripiprazole. Diabetes Care. 2006, 29: 2329-2330. 10.2337/dc-06-1393.View ArticlePubMedGoogle Scholar

[Dhai Salim Alqurashi, Rougaih Abdullah Habib, Shada Abdurahman Alharthi, Waleed Shuwayyikh Alanazi, Mustafi Jamal Alkhanani, Ahmed Salim Mohmoud Elshigagi,Racan Talat Sharbini, Albaraa Ahmed Izzudeen, Abdulrahman Saleh Alhadlag, Mohammed abobakr Alammari, Taghreed Kamel Alnajjar, Khadeejah Talib Aljifri, Alanoud mohammed Aljadeed, Asma Ali Alharbi, Nourah Hudayban Almukhlifi, Bayan Abdulkarim Kharsan, Asma Saad AL ahmari and Sabah Abdulrahman Khozam. (2017); DIABETIC CONTROL AND ATYPICAL ANTIPSYCHOTICS: A CASE REPORT. Int. J. of Adv. Res. 5 (1). 666-669] (ISSN 2320-5407). www.journalijar.com

Dhai Salim Alqurashi


Article DOI: 10.21474/IJAR01/2796       DOI URL: http://dx.doi.org/10.21474/IJAR01/2796

Share this article