Document Detail


Undiagnosed hyperglycemia in patients treated with atypical antipsychotics.
MedLine Citation:
PMID:  16420085     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The use of atypical antipsychotics has been associated with abnormalities of glucose metabolism in patients with schizophrenia. This study was designed to determine the proportion of undiagnosed hyperglycemia in patients receiving a broad range of atypical antipsychotics. METHOD: All outpatients treated at an urban Veterans Affairs medical center who received a prescription for clozapine, risperidone, olanzapine, quetiapine, or ziprasidone were identified, and an attempt was made to obtain a fasting plasma glucose (FPG) test. Testing took place October 2000 to November 2002. Patients previously diagnosed as diabetic were excluded. RESULTS: Of the 647 patients who received antipsychotic prescriptions and were not diagnosed as diabetic, 494 (76.4%) had a random glucose result, while 153 (23.6%) had an FPG result. Within the FPG group, 107 (69.9%) had a normal FPG level, while 46 (30.1%) had an abnormally elevated FPG. There were no differences between these 2 groups in terms of race/ethnicity, age, body mass index, or comorbid diagnoses. However, significantly more patients receiving clozapine were found to have occult hyperglycemia (p = .001); no significant differences in the percentage of patients with FPG levels > or = 100 mg/dL and those with FPG levels < 100 mg/dL were observed for any of the other medications. CONCLUSION: Hyperglycemia is common in patients treated with atypical antipsychotics and thought to be euglycemic. Screening for elevated FPG is indicated for patients receiving atypical antipsychotics.
Authors:
Michael J Sernyak; Barbara Gulanski; Robert Rosenheck
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of clinical psychiatry     Volume:  66     ISSN:  0160-6689     ISO Abbreviation:  J Clin Psychiatry     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2006-01-19     Completed Date:  2006-01-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7801243     Medline TA:  J Clin Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1463-7     Citation Subset:  IM    
Affiliation:
Psychiatry Service 116A, VA Connecticut Healthcare System, West Haven Campus, 950 Campbell Avenue, West Haven, CT 06516, USA. michael.sernyak@yale.edu
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MeSH Terms
Descriptor/Qualifier:
Ambulatory Care
Antipsychotic Agents / adverse effects*,  therapeutic use
Blood Glucose / analysis
Clozapine / adverse effects,  therapeutic use
Comorbidity
Connecticut / epidemiology
Diabetes Mellitus / chemically induced*,  diagnosis*,  epidemiology
Drug Therapy, Combination
Female
Glucose Tolerance Test / statistics & numerical data*
Hospitals, Veterans / statistics & numerical data
Humans
Hyperglycemia / chemically induced*,  diagnosis*,  epidemiology
Male
Mass Screening
Mental Disorders / blood,  drug therapy*,  epidemiology
Middle Aged
Sampling Studies
Schizophrenia / blood,  drug therapy,  epidemiology
Chemical
Reg. No./Substance:
0/Antipsychotic Agents; 0/Blood Glucose; 5786-21-0/Clozapine

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