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Risk of diabetes and dyslipidemia during clozapine and other antipsychotic drug treatment of schizophrenia in Iceland.

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Authors
Ingimarsson, Oddur
MacCabe, James H
Haraldsson, Magnús
Jónsdóttir, Halldóra
Sigurdsson, Engilbert
Issue Date
2017-10

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Citation
Risk of diabetes and dyslipidemia during clozapine and other antipsychotic drug treatment of schizophrenia in Iceland. 2017, 71 (7):496-502 Nord J Psychiatry
Abstract
Type 2 diabetes (T2D) and raised blood lipids are associated with the use of antipsychotics, not least clozapine.
To describe the prevalence of high blood glucose levels, T2D, and dyslipidemia, in association with the use of clozapine or other antipsychotics in patients with schizophrenia in Iceland.
This study identified 188 patients treated with clozapine and 395 patients never treated with clozapine by searching the electronic health records of Landspitali, the National University Hospital. The comparison group consisted of Icelandic population controls. Data were obtained on blood glucose, HbA1c, and blood lipid levels from these health records.
The prevalence of T2D was 14.3% in the clozapine group, where the mean age was 51.2 years, and 13.7% in the never-on-clozapine group, where the mean age was 58.6 years. Males on clozapine were 2.3-times more likely and females 4.4-times more likely to have developed T2D than controls from an age-adjusted Icelandic cohort, while males on other antipsychotics were 1.5-times more likely and females 2.3-times as likely to have T2D than controls. Only one case of ketoacidosis was identified. Triglyceride levels were significantly higher in both treatment groups compared to controls in the age-adjusted Icelandic cohort.
Clinicians must take active steps to reduce the risk of T2D and raised triglycerides in patients with schizophrenia. Antipsychotics were associated with a greater risk of T2D developing in females compared to males.
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Additional Links
http://www.tandfonline.com/doi/pdf/10.1080/08039488.2017.1334821?needAccess=true
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Archived with thanks to Nordic journal of psychiatry
ae974a485f413a2113503eed53cd6c53
10.1080/08039488.2017.1334821
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