Possible Interaction: Glucose and Antipsychotic Agents

“This comprehensive literature review considers the evidence for and against an association between glucose or lipid dysregulation and eight separate second-generation antipsychotics currently available in the US and/or Europe, specifically clozapine, olanzapine, risperi-done, quetiapine, zotepine, amisulpride, ziprasidone and aripiprazole.”

“It is currently established that SGAs may induce metabolic adverse events (AEs) such as weight gain, perturbation of blood lipids or glucose with risk of potential cardiovascular morbidity and mortality.”

“In a natural real-world drug-naive first-episode schizophrenia (FES) inpatient cohort, we reported that levels of fasting glucose , serum albumin, and urea nitrogen were significantly decreased after shortterm antipsychotics exposure.”

“Recent studies have shown that patients treated with APs for schizophrenia were more likely to exhibit impaired glucose tolerance after a glucose load compared with healthy control subjects, even if fasting glucose levels were within the reference range.”

“This case demonstrates the importance of a careful monitoring of glucose and other metabolic parameters in patients receiving atypical antipsychotics.”

“Routine monitoring of glucose and lipid levels during treatment with novel antipsychotics should be advocated.”

“Since it seemed possible that excessive rises of lactate and pyruvate observed after ingestion of glucose in psychotic patients might also be reflected in abnormal utilization of lactate itself, studies with intravenous lactate were undertaken.”

“ Antipsychotics , such as risperidone, increase food intake and induce alteration in glucose and lipid metabolism concomitantly with overweight and body fat increase, these biological abnormalities belong to the metabolic syndrome definition (high visceral adiposity, hypertriglyceridemia, hyperglycemia, low HDL-cholesterol and high blood pressure).”

“Together, these findings indicate that acute administration of antipsychotic drugs has potent effects on metabolic regulation of glucose and insulin sensitivities, which may contribute to metabolic side-effects seen in humans.”

“However, 5-HT1A receptor agonists increase plasma corticosterone and many antipsychotics disturb the regulation of glucose.”