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Could Schizophrenia Drug Cause Diabetes?

Duke University scientists say evidence indicates a relationship

MONDAY, July 1, 2002 (HealthDayNews) -- Dramatizations like "A Beautiful Mind" aside, most people suffering from schizophrenia need drugs to cope with reality.

But could the cost of successful treatment mean contracting diabetes? Duke University researchers think there might be a link between one drug used to treat schizophrenia and diabetes.

The drug is called olanzapine, and it's one of a group of medications called atypical antipsychotics, which are used to treat schizophrenia, paranoia and manic-depressive disorders.

The research results were dramatic, because scientists found not only mild blood sugar problems, but also discovered a serious condition called diabetic ketoacidosis and coma in patients who had been prescribed olanzapine, whose commercial name is Zyprexa. Most of the subjects in the study had not been known to have any diabetes problems at all.

The findings appear in the July 2, 2002 issue of Pharmacotherapy.

Diabetic ketoacidosis (DKA) causes an extreme elevation in blood glucose levels, coupled with a severe lack of insulin. This results in nausea, vomiting, stomach pain and rapid breathing. If it's left untreated, DKA can be fatal.

According to a Duke University press release, Dr. P. Murali Doraiswamy, a psychiatrist at Duke and co-author of the study, was cautious about a direct cause-and-effect relationship in the study: "While our report does not prove a causal relationship between the drug and diabetes, doctors should be aware of such potentially adverse effects," said Doraiswamy. "We've found cases where patients had some very serious problems associated with olanzapine, and at least 23 of them died."

The lead author of the study was Dr. Elizabeth A. Koller, a medical officer at the U.S. Food and Drug Administration, who used abstracts from psychiatric studies over a period of eight years. Researchers identified 289 cases of diabetes in patients who had been given olanzapine.

The press release gave the following findings:

  • Of the 289 cases of diabetes linked to the use of olanzapine, 225 were newly diagnosed cases.
  • One hundred patients developed ketosis, a serious complication of diabetes.
  • Twenty-two people developed pancreatitis, or inflammation of the pancreas, which is a life-threatening condition.
  • There were 23 deaths, including that of a 15-year-old adolescent who died of necrotizing pancreatitis, a condition where the pancreas breaks down and dies.
  • Most cases (71 percent) occurred within six months of starting the drug and many cases were associated with moderate weight gain.

More information

This article from the National Institute of Mental Health gives an update on treatment for schizophrenia, and explains what the illness is and is not.

SOURCE: News release, Duke University Medical Center, July 1, 2002
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