Diabetes and antipsychotic drugs

Abstract

There is an increased risk of diabetes in patients with schizophrenia and this risk is elevated by some antipsychotic medications. The risk is greater with the atypical drugs clozapine and olanzapine and the low potency conventional antipsychotics than with risperidone or high potency conventional drugs. While weight gain may be a mechanism for the development of diabetes, a direct effect of these drugs on insulin action in muscle may also be an important contributor. Patients with major psychosis should be managed in the same way as other patients with diabetes, but difficulties in complying with diet, exercise and taking medication should be kept in mind. Treating cardiovascular risk factors is important.