Diabetes Risk Increased with Atypical Antipsychotics in Children

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Diabetes Risk Increased with Atypical Antipsychotics in Children

Children who take these drugs or antidepressants require rigorous monitoring for diabetes, especially during the first 6 months of therapy.

Incidence of diabetes mellitus (DM) in children on atypical antipsychotics (AAs) is not well known. These researchers examined incident cases of DM in such children via retrospective chart diagnosis or pharmacy records of prescribed DM medications, or via an additional laboratory criterion (hemoglobin A_1c, $≥$ 7%; fasting blood sugar level, $≥$ 126 mg/dL; or random blood sugar level, $≥$ 200 mg/dL). The database comprised more than 700,000 children (age range, 5–18 years). Comparison groups were children not receiving psychotropic medications and children receiving antidepressants.

Primary DM criteria were met by 12 of 9636 children with new AA prescriptions, 19 of 26,265 children with new antidepressant prescriptions, and 26 of 38,544 children not taking psychotropics (15, 51, and 38, respectively, met primary or laboratory criteria). Mean time to DM was 138 days in the AA group, 143 days in the antidepressant group, and 173 days in the no-psychotropic group. Depending on the analysis, DM incidence was 3 to 4 times higher in the AA group and 2 to 4 times higher in the antidepressant group than in the no-psychotropic group. DM rates in the two drug groups significantly differed from the rate in the no-psychotropic group, but not from each other. In the AA group, risk was elevated for DM defined by primary or laboratory criteria.

Comment: Although sample size was small, these findings are consistent with the weight gain seen in children soon after prescription of atypical antipsychotics (JW Psychiatry Nov 9 2009) and are of great concern because of the recent marked increase in pediatric antipsychotic prescriptions (JW Psychiatry Jun 21 2006). Physicians need to inform parents about diabetes risk with AAs or antidepressants and to rigorously monitor patients for diabetes, especially during the first 6 months of therapy.

— Barbara Geller, MD

Published in Journal Watch Psychiatry January 9, 2012

Citation(s):

Andrade SE et al. Antipsychotic medication use among children and risk of diabetes mellitus. Pediatrics 2011 Dec; 128:1135.

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