Children, Youth Prescribed Antipsychotic Drugs Appear at Higher Risk for Type 2 Diabetes

 

Children and youth prescribed antipsychotic medications appear to have a three-fold increased risk for type 2 diabetes mellitus, according to a report published by JAMA Psychiatry, a JAMA Network publication.

Increasing antipsychotic medication use among children and youth is raising concerns that this practice may increase the risk of type 2 diabetes. Antipsychotic drug use among adults appears to be associated with an increased risk of type 2 diabetes, the authors write in the study background.

William V. Bobo, M.D., M.P.H., of the Vanderbilt University School of Medicine, Nashville, and colleagues conducted a study of children and youth (between the ages of 6 and 24 years) in the Tennessee Medicaid program with 28,858 recent initiators of antipsychotic drugs and 14,429 matched control patients who had recently initiated another psychotropic medication. The control group medications included mood stabilizers (eg. lithium), antidepressants, psychostimulants, ɑ-agonists (with diagnosed attention-deficit/hyperactivity disorder [ADHD] or other behavior/conduct problems), and benzodiazepines (with a psychiatric diagnosis).

Researchers noted 106 incident cases of type 2 diabetes (18.9 cases per 10,000 person-years) during follow-up. The mean age of the patients was 16.7 years and 37 percent were male.

Users of antipsychotic drugs was associated with a three-fold increased risk for type 2 diabetes (hazard ratio [HR], 3.03), which was apparent within the first year of follow-up. The risk remained increased for up to one year following discontinuation of antipsychotic use (HR, 2.57), according to the study results.

“In conclusion, in the study cohort of children and youth between 6 and 24 years of age, those recently initiating an antipsychotic medication had a three-fold greater risk of newly diagnosed type 2 diabetes than did propensity score-matched controls. Risk was elevated during the first year of antipsychotic use, increased with increasing cumulative dose, and was present for children younger than 18 years of age,” the study concludes.

(JAMA Psychiatry. Published online August 21, 2013. doi:10.1001/jamapsychiatry.2013.2053