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Diabetes Risk Potentially Underestimated in Youth and Children Receiving Antipsychotics

Diabetes Risk Potentially Underestimated in Youth and Children Receiving Antipsychotics Letters We used an individualized approach reducing the dose as much were misidentified. The study’s observation that risk as feasible without recurrent symptoms; some patients dis- increased in the first year suggests antipsychotics either continued, but most continued to receive a low dose. A fixed- rapidly induce diabetes or rapidly progress undetected dia- dose approach puts the cart before the horse, returning to non- betes or prediabetes. personalized treatment. Nonetheless, the clinical implications of this article are, in our view, clear. Antipsychotics should be used with caution in children and youth, where indicated, and only when non- Lex Wunderink, MD, PhD pharmacologic interventions and lower-risk nonantipsy- Sjoerd Sytema, PhD chotic options have failed. If still required, a low-risk antipsy- chotic should be selected. Further, routine metabolic Author Affiliations: Department of Research and Education, Friesland Mental complication monitoring is mandatory, as are lifestyle inter- Health Services, Leeuwarden, the Netherlands (Wunderink); Department of 3-5 ventions to prevent diabetes. Monitoring and preventive in- Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands (Wunderink, Sytema). tervention should be components of the standard of care, in- Corresponding Author: Lex Wunderink, MD, PhD, Department of Research and stigated at antipsychotic initiation. Supporting the http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Psychiatry American Medical Association

Diabetes Risk Potentially Underestimated in Youth and Children Receiving Antipsychotics

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Diabetes Risk Potentially Underestimated in Youth and Children Receiving Antipsychotics

Abstract

Letters We used an individualized approach reducing the dose as much were misidentified. The study’s observation that risk as feasible without recurrent symptoms; some patients dis- increased in the first year suggests antipsychotics either continued, but most continued to receive a low dose. A fixed- rapidly induce diabetes or rapidly progress undetected dia- dose approach puts the cart before the horse, returning to non- betes or prediabetes. personalized treatment. Nonetheless, the...
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Publisher
American Medical Association
Copyright
Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-622X
eISSN
2168-6238
DOI
10.1001/jamapsychiatry.2013.4030
pmid
24500630
Publisher site
See Article on Publisher Site

Abstract

Letters We used an individualized approach reducing the dose as much were misidentified. The study’s observation that risk as feasible without recurrent symptoms; some patients dis- increased in the first year suggests antipsychotics either continued, but most continued to receive a low dose. A fixed- rapidly induce diabetes or rapidly progress undetected dia- dose approach puts the cart before the horse, returning to non- betes or prediabetes. personalized treatment. Nonetheless, the clinical implications of this article are, in our view, clear. Antipsychotics should be used with caution in children and youth, where indicated, and only when non- Lex Wunderink, MD, PhD pharmacologic interventions and lower-risk nonantipsy- Sjoerd Sytema, PhD chotic options have failed. If still required, a low-risk antipsy- chotic should be selected. Further, routine metabolic Author Affiliations: Department of Research and Education, Friesland Mental complication monitoring is mandatory, as are lifestyle inter- Health Services, Leeuwarden, the Netherlands (Wunderink); Department of 3-5 ventions to prevent diabetes. Monitoring and preventive in- Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands (Wunderink, Sytema). tervention should be components of the standard of care, in- Corresponding Author: Lex Wunderink, MD, PhD, Department of Research and stigated at antipsychotic initiation. Supporting the

Journal

JAMA Psychiatry – American Medical Association

Published: Feb 1, 2014

References

  • Antipsychotics and the risk of type 2 diabetes mellitus in children and youth.
    Bobo, WV; Cooper, WO; Stein, CM
  • National trends in the office-based treatment of children, adolescents, and adults with antipsychotics.
    Olfson, M; Blanco, C; Liu, SM; Wang, S; Correll, CU
  • Evidence-based recommendations for monitoring safety of second generation antipsychotics in children and youth.
    Pringsheim, T; Panagiotopoulos, C; Davidson, J; Ho, J
  • The heart of the matter: cardiometabolic care in youth with psychosis.
    Curtis, J; Newall, HD; Samaras, K
  • Metabolic and cardiovascular adverse effects associated with antipsychotic drugs.
    De Hert, M; Detraux, J; van Winkel, R; Yu, W; Correll, CU