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Patients on Atypical Antipsychotic Drugs: Another High-Risk Group for Type 2 Diabetes

Response to Lean and Pajonk

From Eli Lilly, Indianapolis, Indiana

Address correspondence to Thomas Hardy, MD, PhD, U.S. Endocrinology, Drop Box 5116, Lilly Corporate Center, Indianapolis, IN 46285. E-mail: hardyta@lilly.com

The first 20% of the full text of this article appears below.

The potential contribution of antipsychotic medication to the risk of diabetes in patients with severe mental illness has received significant attention in the psychiatric literature (1). In a recent review in Diabetes Care, Lean and Pajonk (2) claim to have summarized the "evidence for a causal link" between certain atypical antipsychotics and diabetes. However, their argument relies largely on spontaneous reports and retrospective, or uncontrolled, studies that are not suited to address causation. Furthermore, recent controlled prospective studies raise doubts about the authors’ suggestion of a "direct metabolic effect" for drugs such as olanzapine.

The authors use case reports to argue for differential "diabetogenic potential of the atypical antipsychotics " (in Table 1 of their article) and claim that risperidone "appears to have the least propensity to cause diabetes." They did not cite studies by Koller et al. (3) and Hedenmalm et al. (4) . . . [Full Text of this Article]

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				M. E.J. Lean and F.-G. Pajonk Patients on Atypical Antipsychotic Drugs: Another High-Risk Group for Type 2 Diabetes: Response to Hardy and Breier Diabetes Care, November 1, 2003; 26(11): 3202 - 3203. [Full Text] [PDF]