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Title: Quetiapine Linked with New-Onset Diabetes: Presented at ANA

"Quetiapine Linked with New-Onset Diabetes: Presented at ANA"

By Jill Stein SAN FRANCISCO, CA -- November 14, 2003 -- Quetiapine may increase the risk of new-onset diabetes, researchers reported here on October 19th at the 128th Annual Meeting of the American Neurological Association (ANA). Dr. Martha Trieschmann and colleagues, Brown University, Providence, Rhode Island, United States, reviewed the charts of all patients with parkinsonian symptoms who were being followed at the university's movement disorders clinic. They identified 23 patients on quetiapine therapy for longer than 3 months. A comparison of the rates of diabetes in this cohort with the rates of diabetes in the general population showed a possible link between long-term quetiapine therapy and development of new-onset diabetes. Compared to the general population, parkinsonian patients treated with quetiapine for more than 3 months had a greater prevalence of diabetes (28% versus 10.6% for the two groups, respectively) and incidence (13% versus 0.45%, respectively). Age was the sole factor that significantly correlated with the risk of diabetes in the patients in this study. Specifically, diabetes was associated with younger age. Similar findings have been described in schizophrenia, with younger schizophrenic patients being more susceptible to clozapine-induced diabetes, Dr. Trieschmann pointed out. Another study showed clozapine, olanzapine and quetiapine but not risperidone to be associated with a higher prevalence of diabetes compared with conventional neuroleptics. However, in patients younger than 40 years of age, risperidone, too, was associated with a higher prevalence of diabetes compared to typical neuroleptics. Dr. Trieschmann said that this is the first study to evaluate the prevalence of diabetes in parkinsonian patients on long-term quetiapine. To her knowledge, only one other study has examined the prevalence of diabetes related to any other atypical antipsychotic, she said. How quetiapine and other atypical antipsychotics are related to diabetes remains unclear, she noted. "Quetiapine has been associated with weight gain, and this increase in body weight may be at least in part responsible for the increased risk of new-onset diabetes," she said. "The drugs have also been linked to hypertriglyceridaemia. Increased appetite, insulin resistance, and other endocrine changes may also play a role." Finally, she emphasised that further studies are needed to better delineate the risk of new-onset diabetes associated with quetiapine and other atypical antipsychotics. In the meantime, neurologists and primary care physician should be aware of this risk and monitor quetiapine-treated parkinsonian patients for the development of diabetes, particularly younger patients, she said. [Study title: New Onset Diabetes in Parkinsonian Patients on Long-Term Quetiapine. Poster 25]

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