Antipsychotic Drugs Risk Seniors With Diabetes
Antipsychotic medication is associated with a higher risk of hospitalization for high blood sugar (hyperglycemia) in seniors with diabetes according to a study led by researchers at the Institute for Clinical Evaluative Sciences (ICES) and Women’s College Research Institute at Women’s College Hospital. And despite several recent warnings of higher risk of stroke and mortality, antipsychotic drugs, usually recommended for patients with schizophrenia, continue to be used to control behavioral symptoms of dementia.
The study, to be published in the July 27 issue of Archives of Internal Medicine, found seniors with diabetes who were newly treated with an antipsychotic medication were 50 per cent more likely to be hospitalized for hyperglycemia compared to those who were not taking the drug. The greatest risk appeared to be right after the first prescription for an antipsychotic, at which time there was a 6 to 15-fold rise in hospitalizations for high blood sugar.
“This indicates that patients with diabetes are more vulnerable to sudden worsening of their glucose control during the initiation of antipsychotic drugs,” says principal investigator Dr. Lorraine Lipscombe, who is also a scientist at ICES and Women's College Research Institute. “This is particularly significant for the elderly because they are the biggest group of patients with diabetes, and are already the most vulnerable to poor diabetes control.”
The study looked at 13,817 patients in Ontario, 66 years of age or older with diabetes who started antipsychotic treatment between April 1, 2002 and March 31, 2006.
“Our findings suggest that options other than antipsychotic drugs should be considered for seniors with diabetes who have behavioral symptoms of dementia,” says Dr. Lipscombe. “If antipsychotic drugs are to be used, patients and families should pay close attention to signs of deterioration in glucose control, and be more vigilant about glucose monitoring.”
This research focused on whether antipsychotic drugs increase the risk of hyperglycemia in patients with diabetes, though further research is needed to determine if the drugs increase the risk of developing diabetes for those who don’t yet have the disease.