![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by John Bower on August 25, 2001, at 23:15:09
Note:
Risperdal seems ok -- I read the article, you read it too.DIABETES MELLITUS ASSOCIATED WITH ATYPICAL ANTIPSYCHOTIC MEDICATIONS:
NEW CASE REPORT AND REVIEW OF THE LITERATURE
During the past 6 years several case reports have surfaced in the
literature that seem to associate diabetes mellitus with use of new
atypical antipsychotic medications.
J Am Board Fam Pract 14(4):278-282, 2001
http://psychiatry.medscape.com/42001.rhtml?srcmp=psy-082401
< a href="http://psychiatry.medscape.com/42001.rhtml?srcmp=psy-082401" >
Read it Here< /a >
Posted by SLS on August 26, 2001, at 7:18:15
In reply to diabetes and atypical anti-psychotics, posted by John Bower on August 25, 2001, at 23:15:09
> Note:
> Risperdal seems ok -- I read the article, you read it too.
>
> DIABETES MELLITUS ASSOCIATED WITH ATYPICAL ANTIPSYCHOTIC MEDICATIONS:
> NEW CASE REPORT AND REVIEW OF THE LITERATURE
> During the past 6 years several case reports have surfaced in the
> literature that seem to associate diabetes mellitus with use of new
> atypical antipsychotic medications.
> J Am Board Fam Pract 14(4):278-282, 2001
> http://psychiatry.medscape.com/42001.rhtml?srcmp=psy-082401
> < a href="http://psychiatry.medscape.com/42001.rhtml?srcmp=psy-082401" >
> Read it Here< /a >
I think Clozaril (clozapine) and Zyprexa (olanzapine) are the two drugs capable of producing alterations in glucose dynamics and diabetes.
- Scott
Posted by Cam W. on August 26, 2001, at 7:33:59
In reply to diabetes and atypical anti-psychotics, posted by John Bower on August 25, 2001, at 23:15:09
John - I was talking to the Zyprexa rep the other day (met him in Starbucks, as he was interviewing a new rep), and he says that the increased incidence of type II diabetes is only seen in patients with schizophrenia (he later amended that to be, that patients with schizophrenia were the only one's studied, so far). The reason he states that there increased numbers of people getting diabetes from taking Clozaril and Zyprexa is that people with schizophrenia are 4 times as likely as the general population to get diabetes. I asked if this number included unmedicated people and he didn't know. He also blamed increased appetite and poorer than normal dietary skills (eg chips & pop diets), as being risk factors. Those that I see end up with type II diabetes or not, seem to have the same eating habits, in general (of course, I could be mistaken on this).
I really can't believe that we have a number of people with schizophrenia have borderline triglyceride levels and coincidentally become diabetic after starting these two atypical antipsychotics. I have seen people without schizophrenia become diabetic after taking these atypicals, but I am sorry that I never paid attention to relative numbers.
Most of the scientific information has been done on Clozaril, but clinically, it is seen with Zyprexa, as well (maybe not as high a percentage, though).
- Cam
Posted by Zo on August 26, 2001, at 22:28:15
In reply to Re: diabetes and atypical anti-psychotics » John Bower, posted by Cam W. on August 26, 2001, at 7:33:59
Cam,
What do you think of taking Glucophage to counter the blood sugar effects of Zyprexa? My pdoc's thinking about it. . if Buprenex doesn't work for me.Thanks,
Zops: I hope things are square btwn. us. I like you. I just felt strongly, as I posted on Admin., and 'twas meant to be, in the long run, supportive of you.
Posted by Cam W. on August 27, 2001, at 1:15:25
In reply to Re: diabetes and atypical anti-psychotics » Cam W., posted by Zo on August 26, 2001, at 22:28:15
Zo - Definitely no hard feelings; I said too much and have now adopted a wait and see attitude. I keep forgetting that I cannot save everyone, but I have a very strong, ominous feeling about the whole situation (call it a hunch; ie. hairs on my neck stand up).
There has been some take of using Glucophage™ (metformin). I first heard of this at a dynamic and thought-provoking presentation by Dr.Richard Petty (some of you may remember my post where I said that Dr.Petty considered schizophrenia and bipolar disorder to be different manifestations of the dysfunction - ie. same disorder, varied intensity -on a continuum).
Dr.Petty stated that, in his experience, 500mg of Glucophage, three times a day, prevented weight gain in a large number of his patients, with schizophrenia, started on Zyprexa. I have seen no large scale clinical or case studies confirming or denying these allegations. One could assume that someone who has a borderline propensity for type-II diabetes may not gain any weight taking Zyprexa, because the glucophage would prevent the hypertriglyceridemia (is that a word?) from turning into type-II diabetes.
I am not positive this theory works in real life (looks good on paper, though). I will have to wait for researchers to tease out the connection &/or mechanism) of the Zyprexa (Clozaril)/diabetes interaction, before I am convinced one way or the other.
That being said, Glucophage 500mg two or three times daily, in many cases, was enough to lower Zyprexa-induced triglyceride levels. Sometimes Diamicron™ (glicazide) or other newer oral antihyperglycemic was added; depending upon the level of control needed.
FYI - In cases like this that I followed, there was no significantly obvious decrease in weight, but there was better control of blood sugar levels. I believe that Dr.Petty said that the Glucophage "prevented" Zyprexa-induced weight gain.
Still, the Glucophage is worth a try, especially when trying to get blood sugar levels under control. A word of warning, though; Glucophage will make you "toot" (from my 6 yr. old's vernacular), a lot.
I hope that this is of some help. - Cam
Posted by Zo on August 27, 2001, at 14:35:03
In reply to Re: diabetes and atypical anti-psychotics » Zo, posted by Cam W. on August 27, 2001, at 1:15:25
> Zo - Definitely no hard feelings; I said too much and have now adopted a wait and see attitude. I keep forgetting that I cannot save everyone, but I have a very strong, ominous feeling about the whole situation (call it a hunch; ie. hairs on my neck stand up).
>Wow. I gotta say, I have great respect for hunches, especially for ones involving the little hairs on the back of the neck. Hopefully, though, as The Man posted, there is enough counterweight on PB so that no one takes in just one person's view. If that were the case, well, that could happen anywhere, so in a way the board cannot be to blame. . if that makes sense.
THANK YOU so much for this. . .sent it right off to my pdoc. I'm going to try buprenorphine troches he has made up, first. . .cause we already know I *lurve* Zyprexa. Liposuction? Roto-Rooter? I think I could even deal with being a fat person, but it was being CAPTIVE of food and appetite, it's awful.
Glad to be friends.
I've noticed some meds are big tooters, some not. Someone ought to study the science of *that.*
Zo
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.