Schizophrenia: combination therapy tied to increased T2D risk

  • Mamakou V & al.
  • BMC Psychiatry
  • 2 Aug 2018

  • curated by Jim Kling
  • Clinical Essentials
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Takeaway

  • Patients with schizophrenia taking 3 or more classes of psychiatric drugs are at significantly greater risk for type 2 diabetes.

Why this matters

  • The results need to be verified by further research but suggest that increases in monotherapy dose or switching to a new drug may carry less T2D risk than combination therapies.

Study design

  • The Genetic Overlap between Metabolic and Psychiatric disease study was a nested case-control study on hospitalized patients with schizophrenia (with type 2 diabetes, n=536; without type 2 diabetes, n=854).
  • Funding: Wellcome.

Key results

  • Treatment with ≥3 psychiatric drugs (antipsychotic+≥2 psychiatric medications) vs first-generation antipsychotics alone was significantly associated with greater risk for type 2 diabetes (aOR, 1.81; P=.003).
  • No significant association between drug use and risk for T2D was noted with:
    • 2-drug combinations (antipsychotic+≥1 psychiatric medications; aOR, 0.98; P=.885) and
    • second-generation antipsychotics (aOR, 1.27; P=.259).

Limitations

  • Retrospective medication information up to 6 months before the study was used.
  • Effect of previous treatment regimens not known.

Coauthored with Chitra Ravi, MPharm

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