Antipsychotic medication use among children and risk of diabetes mellitus
Meyers Primary Care Institute; Department of Medicine, Division of Geriatric Medicine; Department of Medicine, Division of Preventive and Behavioral Medicine
Diabetes Mellitus; Child; Antipsychotic Agents
Endocrine System Diseases | Health Services Research | Pediatrics | Primary Care | Psychiatry
OBJECTIVE: To assess whether the risk of incident diabetes was increased with the use of second-generation antipsychotics (SGAs) in a large diverse cohort of children.
METHODS: A retrospective study was conducted by using the administrative databases of 3 health plans participating in the Health Maintenance Organization Research Network. Children 5 to 18 years of age who initiated SGA therapy between January 2001 and December 2008 and 2 comparison groups, namely, nonusers of psychotropic drugs and users of antidepressant medications, were identified. Diagnoses from inpatient and outpatient records, pharmacy dispensings, and outpatient laboratory results were used to identify incident cases of diabetes.
RESULTS: The crude incidence rate of diabetes for the SGA-exposed cohort was 3.23 cases per 1000 person-years (95% confidence interval [CI]: 1.67-5.65), compared with 0.76 cases per 1000 person-years (95% CI: 0.49-1.12) among nonusers of psychotropic medications and 1.86 cases per 1000 person-years (95% CI: 1.12-2.90) among antidepressant users. The risk of incident diabetes was significantly increased among SGA users (unadjusted incidence rate ratio: 4.24 [95% CI: 1.95-8.72]) in comparison with nonusers of psychotropic medications but was not significantly increased in comparison with antidepressant medication users (unadjusted incidence rate ratio: 1.74 [95% CI: 0.77-3.78]).
CONCLUSIONS: Although we found a potentially fourfold increased rate of diabetes among children exposed to SGAs, the findings were inconsistent and depended on the comparison group and the outcome definition.
Pediatrics. 2011 Dec;128(6):1135-41. Epub 2011 Nov 21.
Andrade, Susan E.; Lo, Joan C.; Roblin, Douglas W.; Fouayzi, Hassan; Connor, Daniel F.; Penfold, Robert B.; Chandra, Malini; Reed, George W.; and Gurwitz, Jerry H., "Antipsychotic medication use among children and risk of diabetes mellitus" (2011). Meyers Primary Care Institute Publications and Presentations. 493.