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Metabolic Differences of Antipsychotics Among the Races

Published online by Cambridge University Press:  07 November 2014

David C. Henderson
David C. Henderson*
Affiliation:
Dr. Henderson is Assistant Professor of Psychiatry in the Department of Psychiatry at Massachusetts General Hospital and, Harvard Medical School, in Boston, Massachusetts
*
David C. Henderson, MD, Freedom Trail Clinic, 25 Saniford St, 2nd Floor, Boston, MA 02114; Tel: 617-912-7853; Fax: 617-742-1305; E-mail: [email protected]
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Abstract

As the United States population continues to grow and diversify, physicians must be equipped to treat patients of different races and ethnicities. Current data suggest that certain ethnic minority groups may be predisposed to a variety of clinical conditions, including obesity, diabetes mellitus, hypertension, dyslipidemia, and cardiovascular disease. Furthermore, as physicians begin to turn more frequently to atypical antipsychotics in psychiatric illness, they face a growing concern regarding the development of metabolic side effects, especially in a US population that is gradually becoming more obese from a demographic standpoint. In addition, certain ethnic groups may be more susceptible to these metabolic effects. The metabolic side effects induced by the atypical antipsychotics vary greatly, with the newer agents generally displaying fewer and less severe side effects, indicating that the particular agent chosen is of critical importance. A risk/benefit assessment, taking into consideration any genetic predisposition, preexisting risk factors, and the side-effect profile of the specific agent, is paramount to the successful management of these patients. The ultimate goal is careful consideration of possible metabolic side effects in patients taking atypical antipsychotics, in order to avoid serious consequences.

Type
Research Article
Information
CNS Spectrums , Volume 10 , Issue S2 , 2005 , pp. 13 - 20
Copyright
Copyright © Cambridge University Press 2005

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References

1.US Census Bureau. Statistical Abstract of the United States, 2001. Available at: http://www.census.gov/prod/2002pubs/01statab/pop.pdf. Accessed October 28, 2004.Google Scholar
2.Third National Health and Nutrition Examination Survey (NHANES III), 2002. Available at: http://www.cdc.gov/nchs/about/major/nhanes/datalink.htm#NHANESIII. Accessed October 28, 2004.Google Scholar
3.Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285:2486–2497.Google Scholar
4.Allison, DB, Fontaine, KR, Heo, M, et al.The distribution of body mass index among individuals with and without schizophrenia. J Clin Psychiatry. 1999;60:215–220.Google Scholar
5.The Collaborative Working Group on Clinical Trial Evaluations. Adverse effects of the atypical antipsychotics. J Clin Psychiatry. 1998;59(suppl 12):17–22.Google Scholar
6.Lamberti, JS, Bellnier, T, Schwarzkopf, SB. Weight gain among schizophrenic patients treated with clozapine. Am J Psychiatry. 1992;149:689–690.Google Scholar
7.Leadbetter, R, Shutty, M, Pavalonis, D, Vieweg, V, Higgins, P, Downs, M. Clozapine-induced weight gain: prevalence and clinical relevance. Am J Psychiatry. 1992;149:68–72.Google Scholar
8.Cohen, S, Chiles, J, MacNaughton, A. Weight gain associated with clozapine. Am J Psychiatry. 1990;147:503–504.Google Scholar
9.Kraus, T, Haack, M, Schuld, A, et al.Body weight and leptin plasma levels during treatment with antipsychotic drugs. Am J Psychiatry. 1999;156:312–314.Google Scholar
10.Gupta, S, Droney, T, Al-Samarrai, S, Keller, P, Frank, B. Olanzapine-induced weight gain. Ann Clin Psychiatry. 1998;10:39.Google Scholar
11.Allison, DB, Mentore, JL, Heo, M, et al.Antipsychotic-induced weight gain: a comprehensive research synthesis. Am J Psychiatry. 1999;156:1686–1696.CrossRefGoogle ScholarPubMed
12.Nemeroff, CB. Dosing the antipsychotic medication olanzapine. J Clin Psychiatry. 1997;58(Suppl 10):45–59.Google Scholar
13.Jones, AM, Rak, IW, Raniwalla, J, Phung, D, Melvin, K. Weight changes in patients treated with Seroquel (quetiapine). Presented at: The Annual Meeting of the American College of Neuropsychopharmacology; December 12-16, 1999; Acapulco, Mexico.Google Scholar
14.Marder, SR. Safety and tolerability of long-term antipsychotic therapy. J Clin Psychiatry. 2003;64(suppl):1379–1390.Google Scholar
15.Henderson, DC, Daley, TB, Louie, P, et al.A placebo-controlled trial of sibutramine added to patients with olanzapine-induced weight gain [abstract 7295]. World J Biol Psychiatry. 2004;5(suppl 1):152.Google Scholar
16.Henderson, DC, Nguyen, D, Daley, TB, et al.Aripipirazole as an adjunct to clozapine therapy in chronic schizophrenics [abstract 7277]. World J Biol Psychiatry. 2004;5(suppl 1):147.Google Scholar
17.King, H, Aubert, RE, Herman, WH. Global burden of diabetes, 1995-2025: prevalence, numerical estimates and projections. Diabetes Care. 1998;21:1414–1431.Google Scholar
18.The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2000;23(Suppl 1):S4–S19.Google Scholar
19.Wirshing, DA, Spellberg, BJ, Erhart, SM, Marder, SR, Wirshing, WC. Novel antipsychotics and new onset diabetes. Biol Psychiatry. 1998;44:778–783.Google Scholar
20.Henderson, DC, Cagliero, E, Gray, C, et al.Clozapine, diabetes mellitus, weight gain, and lipid abnormalities: a five-year naturalistic study. Am J Psychiatry. 2000;157:975–981.Google Scholar
21.Resnick, HE, Valsania, P, Halter, JB, Lin, X. Differential effects of BMI on diabetes risk among black and white Americans. Diabetes Care. 1998;21:1828–1835.Google Scholar
22.United States Renal Data System (USRDS). 2000 Annual Data Report. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases—Division of Kidney, Urologic, and Hematologic Diseases. Available at: www.usrds.org. Accessed February 28, 2005.Google Scholar
23.American Diabetes Association, American Psychiatric Association, American Association of Clinical Endocrinologists, North American Association for the Study of Obesity. Consensus development conference on antipsychotic drugs and obesity and diabetes. J Clin Psychiatry. 2004;65:267–272.Google Scholar
24.Koller, EA, Doraiswamy, M. Olanzapine-associated diabetes mellitus. Pharmacotherapy. 2002;22:841–852.Google Scholar
25.Koller, EA, Cross, JT, Doraiswamy, PM, Schneider, BS. Risperidone-associated diabetes mellitus: a pharmacovigilance study. Pharmacotherapy. 2003;23:735–744.CrossRefGoogle ScholarPubMed
26.Koller, E, Schneider, B, Bennett, K, Dubitsky, G. Clozapine-associated diabetes. Am J Med. 2001;111:716–723.Google Scholar
27.Koller, EA, Weber, BS, Doraiswamy, PM, Schneider, BS. A survey of reports of quetiapine-associated hyperglycemia and diabetes mellitus. J Clin Psychiatry. 2004;65:857–863.Google Scholar
28.Henderson, DC, Daley, TB, Nguyen, DD, et al.Clozapine and cardiovascular risk: ten year estimates. Presented at: The International Congress of Biological Psychiatry; February 9-13, 2004; Sydney, Australia.Google Scholar
29.Newcomer, JW, Haupt, DW, Fucetola, R. Abnormalities in glucose regulation during antipsychotic treatment of schizophrenia. Arch Gen Psychiatry. 2002;59:337–345.CrossRefGoogle ScholarPubMed
30.Henderson, DC, Cagliero, E, Copeland, PM, et al.Glucose metabolism in patients with schizophrenia treated with atypical antipsychotic agents: a frequently sampled intravenous glucose tolerance test and minimal model analysis. Arch Gen Psychiatry. 2005;62:19–28.Google Scholar
31.DeFronzo, RA, Ferrannini, E. Insulin resistance. A multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes Care. 1991;14:173–194.Google Scholar
32.Lewis, GF, Carpentier, A, Adeli, K, Giacca, A. Disordered fat storage and mobilization in the pathogenesis of insulin resistance and type 2 diabetes. Endocr Rev. 2002;23:201–229.Google Scholar
33.Koro, CE, Fedder, DO, L’Italien, GJ, et al.An assessment of the independent effects of olanzapine and risperidone exposure on the risk of hyperlipidemia in schizophrenic patients. Arch Gen Psychiatry. 2002;59:1021–1026.Google Scholar
34.Brown, CD, Higgins, M, Donato, KA, et al.Body mass index and the prevalence of hypertension and dyslipidemia. Obes Res. 2000;8:605–619.Google Scholar
35.Nasrallah, HA, Perry, CL, Love, E, Nasrallah, AT. Ethnicity differences in hypertriglyceridemia secondary to olanzapine treatment [abstract B41]. Schizophrenia Res. 2002;53(suppl 1):165–166.Google Scholar
36.Henderson, DC, Nguyen, DD, Daley, TB, Kunkel, L, Louie, PM, Goff, DC. An exploratory open label trial of aripiprazole as an adjuvant to clozapine therapy in chronic schizophrenia. Presented at: The International Congress of Biological Psychiatry; February 9-13, 2004; Sydney, Australia.Google Scholar
37.Henderson, DC, Daley, TB, Kunkel, L, Rodrigues-Scott, M, Koul, P, Hayden, D. Clozapine and hypertension: a chart review of 82 patients. J Clin Psychiatry. 2004;65:686–689.Google Scholar
38.Theisen, FM, Linden, A, Geller, F. Prevalence of obesity in adolescent and young adult patients with and without schizophrenia and in relationship to antipsychotic medication. J Psychiatric Res. 2001;35:339–345.Google Scholar
39. Diabetes in the mentally ill: are antipsychotics involved? Available at: http://diabetic-lifestyle.com/articles/sep01_whats_1.htm. Accessed September 14, 2004.Google Scholar
40.Herrán, A, de Santiago, A, Sandoya, M, Fernández, MJ, Díez-Manrique, JF, Vázquez-Barquero, JL. Determinants of smoking behavior in outpatients with schizophrenia. Schizophrenia Res. 2000;41:373–381.Google Scholar
41.Allebeck, P. Schizophrenia: a life-shortening disease. Schizophrenia Bull. 1989;15:81–89.Google Scholar
42.Mortensen, PB, Juel, K. Mortality and causes of death in first admitted schizophrenic patients. Br J Psychiatry. 1993;163:183–189.Google Scholar
43.Ösby, U, Correia, N, Brandt, L, Ekbom, A, Sparén, P. Mortality and causes of death in schizophrenia in Stockholm County, Sweden. Schizophrenia Res. 2000;45:21–28.Google Scholar
44.Haffner, SM, Lehto, S, Rönnemaa, T, Pyörälä, K, Laakso, M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med. 1998;339:229–234.Google Scholar
45.Wilson, PWF, D’Agostino, RB, Levy, D, Belanger, AM, Silbershatz, H, Kannel, WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97:1837–1847.Google Scholar
46.Henderson, DC. Diabetes mellitus and other metabolic disturbances induced by atypical antipsychotic agents. Curr Diab Rep. 2002;2:135–140.Google Scholar
47.Henderson, DC. Atypical antipsychotic-induced diabetes mellitus. How strong is the evidence? CNS Drugs. 2002;16:77–89.Google Scholar