Objective:This analysis investigates the risk of developing diabetes mellitus among elderly patients aged 60+ during treatment with antipsychotic medications.
Design:Diabetes risk was studied by analyzing new prescription claims for antihyperglycemic agents in the AdvancePCS claim database among elderly patients who initiated antipsychotic therapy within a 3-month period.
Materials and Methods:The following cohorts were studied: (1) an elderly reference population [no antipsychotics used: n=1,836,799], (2) all conventional antipsychotics [n=11,546], (3) haloperidol [n=6481], (4) thioridazine [n=1658], (5) all atypical antipsychotics [n=19,407], (6) clozapine [n=117], (7) olanzapine [n=5382], (8) quetiapine [n=1664], and (9) risperidone [n=12,244].
Results:The incidence of new diabetes was higher in every antipsychotic cohort than in the standard reference population. Risks were not different overall, however, between the atypical and conventional antipsychotic cohorts (2&5). For the individual antipsychotic cohorts, risk was highest for patients treated with thioridazine (95% CI: 3.1–5.7) and lowest for quetiapine (95% CI: 1.3–2.9). Risks for the haloperidol, olanzapine, and risperidone cohorts were intermediate. Among atypicals, only patients treated with risperidone had a significantly higher risk (95% CI: 1.05–1.60, p=.016) than haloperidol. Conclusions about clozapine were hampered by the low number of patients in the cohort
Conclusion:Although causality remains to be demonstrated, diabetes risk was higher among elderly patients receiving antipsychotic treatment than among the general elderly patient population. As a group, risk for atypical antipsychotics was not higher than for conventional antipsychotics, but risperidone’s risk uniquely was significantly higher than haloperidol’s.
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