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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Ed on April 11, 2003, at 13:09:05
Drugs for mental illness may be causing diabetes............04/11/2003
US FDA is confronted with evidence that a new generation of
big-selling drugs such as Zyprexa (Eli Lilly) for Schizophrenia &
other mental illnesses, cause life threatening diabetes symptoms.
Wall Street Journal, Anand & Burton
Posted by linkadge on April 11, 2003, at 14:59:56
In reply to Serious side effect reported, posted by Ed on April 11, 2003, at 13:09:05
These drugs do not cause diabeties.
These drugs can cause weight gain, that
in turn can lead to diabeties.Some people just like to stop by and
tell the board how these drugs aren't
perfect. It is obvious to many here
that they are not.Some people believe that if they can
come on here and bash a med, or bash
the people who use them they have proven
themselves noteworthy.
There are ways to avoid these side effects.
Proper diet and excercise, being the best.
Good Luck
Linkadge
Posted by Ron Hill on April 11, 2003, at 15:59:39
In reply to Serious side effect reported, posted by Ed on April 11, 2003, at 13:09:05
Posted by Larry Hoover on April 11, 2003, at 16:50:44
In reply to Serious side effect reported, posted by Ed on April 11, 2003, at 13:09:05
> Drugs for mental illness may be causing diabetes............04/11/2003
> US FDA is confronted with evidence that a new generation of
> big-selling drugs such as Zyprexa (Eli Lilly) for Schizophrenia &
> other mental illnesses, cause life threatening diabetes symptoms.
> Wall Street Journal, Anand & Burton
Thanks for the heads-up.I am astounded at both the high incidence and the severity of this dysregulation of glucose associated with olanzapine (and other) atypical antipsychotics.
Just use olanzapine and diabetes in any search engine, or in Medline. Astounding that this has not been better publicized, considering it has been nine months since researchers at Duke published a warning.
Look at the incidence.....near 10%. And ketoacidosis. That's serious.
Schizophr Res 2003 Jan 1;59(1):1-6
New-onset diabetes and ketoacidosis with atypical antipsychotics.Wilson DR, D'Souza L, Sarkar N, Newton M, Hammond C.
Department of Psychiatry, Creighton University School of Medicine, Omaha, NE 68131, USA. wilson@creighton.edu
Information from the Ohio Department of Mental Health (ODMH) database was reviewed retrospectively to identify patients at the Cincinnati center treated with an atypical antipsychotic and who had also been evaluated or treated for diabetes mellitus. Blood glucose levels, glucose tolerance, or other evaluations of diabetes had been conducted in 14 of the 126 patients treated with atypical antipsychotics. In 11 of the 14, new-onset, acute, and marked glucose intolerance developed after treatment with clozapine, olanzapine or quetiapine. Of these, six patients required insulin therapy (four only transiently) and five patients developed diabetic ketoacidosis (DKA). Also, glucose metabolism was labile in all cases, and was transient in two cases with subsequent resolution despite on-going antipsychotic therapy. Certain atypical antipsychotics may be associated with new-onset glucose intolerance, including acute diabetes and ketoacidosis. Monitoring for changes in blood glucose levels in patients taking atypical antipsychotics may be indicated. More systematic study data are clearly needed.
Posted by Janelle on April 11, 2003, at 17:31:32
In reply to Serious side effect reported, posted by Ed on April 11, 2003, at 13:09:05
I'm sorry if this is a repeat; I didn't read any of the other threads under here, but thought I would comment that a pdoc told me that the WEIGHT GAIN people have from ZYPREXA has resulted in it being a possible cause of usually adult-onset diabetes. G-d knows what the weight gain would do to children.
Posted by Larry Hoover on April 11, 2003, at 22:46:37
In reply to Re: Serious side effect reported, posted by Janelle on April 11, 2003, at 17:31:32
> I'm sorry if this is a repeat; I didn't read any of the other threads under here, but thought I would comment that a pdoc told me that the WEIGHT GAIN people have from ZYPREXA has resulted in it being a possible cause of usually adult-onset diabetes. G-d knows what the weight gain would do to children.
I feel pedantic to point this out, but the relationship between weight gain and diabetes is correlative, not causative. For all we know, the trend towards diabetes might cause weight gain, or both may be symptoms of a separate pathological process. Symbolically, a correlation between A and B could be explained by: A leads to B, B leads to A, both A and B are caused by C, or a statistical coincidence. The doctor who spoke to you should know better.
Frankly, it looks very much like both the weight gain and the diabetes are caused by Zyprexa, but that is just my educated *guess*.
Lar
Posted by Larry Hoover on April 12, 2003, at 7:25:22
In reply to Re: Serious side effect reported, posted by Larry Hoover on April 11, 2003, at 22:46:37
> > I'm sorry if this is a repeat; I didn't read any of the other threads under here, but thought I would comment that a pdoc told me that the WEIGHT GAIN people have from ZYPREXA has resulted in it being a possible cause of usually adult-onset diabetes. G-d knows what the weight gain would do to children.
>
> I feel pedantic to point this out, but the relationship between weight gain and diabetes is correlative, not causative. For all we know, the trend towards diabetes might cause weight gain, or both may be symptoms of a separate pathological process. Symbolically, a correlation between A and B could be explained by: A leads to B, B leads to A, both A and B are caused by C, or a statistical coincidence. The doctor who spoke to you should know better.I don't know where it went, but here (as best I can remember) is the missing paragraph:
The only way to differentiate among the four possibilities is to collect more information. In the case of Zyprexa, there are a number of reports of the diabetes resolving after withdrawal of the medication. These reports do no mention weight.
> Frankly, it looks very much like both the weight gain and the diabetes are caused by Zyprexa, but that is just my educated *guess*.
>
> Lar
>
Posted by jemma on April 13, 2003, at 13:23:35
In reply to Re: Serious side effect reported, posted by Larry Hoover on April 11, 2003, at 22:46:37
> > I'm sorry if this is a repeat; I didn't read any of the other threads under here, but thought I would comment that a pdoc told me that the WEIGHT GAIN people have from ZYPREXA has resulted in it being a possible cause of usually adult-onset diabetes. G-d knows what the weight gain would do to children.
>
> I feel pedantic to point this out, but the relationship between weight gain and diabetes is correlative, not causative. For all we know, the trend towards diabetes might cause weight gain, or both may be symptoms of a separate pathological process. Symbolically, a correlation between A and B could be explained by: A leads to B, B leads to A, both A and B are caused by C, or a statistical coincidence. The doctor who spoke to you should know better.
>
> Frankly, it looks very much like both the weight gain and the diabetes are caused by Zyprexa, but that is just my educated *guess*.
>
> Lar
>
Hi Larry -As always, I appreciate your careful science and refusal to leap to conclusions from inconclusive data. But I have always suspected that the prime mechanism for med-related weight gain is insulin resistance, and these findings seem to support that. I have also read of good success in preventing and reversing weight gain with the co-administering of glucophage (metformin) along with ads and aps.
- jemma
Posted by missliz on April 14, 2003, at 1:13:46
In reply to Re: Serious side effect reported, posted by jemma on April 13, 2003, at 13:23:35
So the weight gain only makes you die young of heart disease?... Zyprexa was beset by scandal and nasty side effects from the beginning of it's testing phase, and should never have been approved. The FDA rejected it several times. As I recall, a doctor went to jail over it. Read "Mad In America" by Robert Whitaker, it'll scare the bejesus out of you. I wrote the author, and he replied that what went on with Zyprexa scared him- and he doesn't face having it forced on him.
Diabetes is a reletivly minor side effect of Zyprexa, the weight gain so socially cripples people that they're too embarrassed to go out in public. This is treatment?miss liz
Posted by LUKA62 on April 14, 2003, at 23:56:53
In reply to Serious side effect reported, posted by Ed on April 11, 2003, at 13:09:05
I Too recently read an article in a medical journal saying the same thing. I picked it up I think last week while I was waiting to see a doc, and I was concerned with what I read because my kid is on Zyprexa, and while his doc also has him on a med to help him not gain weight, I had not heard about any connection with diabetes. From what I recall it did NOT suggest the incidence of diabetes was mainly a weight issue.
**I will see if I can find this journal back at the dr's office to verify the recent article.***
>> diabetes is hardly a minor side effect no matter how you look at it. Weight gain can indeed be socially crippling, but diabetes can have some very serious medical complications.<<
Posted by LUKA62 on April 15, 2003, at 0:10:43
In reply to Re: Serious side effect reported » Ed, posted by LUKA62 on April 14, 2003, at 23:56:53
I just read down the board the ways where someone posted an article that was in the Wall St Journal...but this is not what I read. At any rate, seems there are conflicting reports out there....
Posted by Med Editor on August 28, 2003, at 11:17:11
In reply to Re: Serious side effect reported, posted by Larry Hoover on April 11, 2003, at 16:50:44
I coming in on this string quite a while after the last post--but I found it while doing Web search for my job. I'm a little disturbed about the bruhaha that has been brewing over the past year or so about the link between olanzapine (Zyprexa) and diabetes, which was given special momentum by a Duke Univ study published in 2002. The study was based on a database review and concluded that olanzapine may induce diabetes and related problems. This remains a controversial issue. Atypical antipsychotics in general may cause weight gain and its sequelae (diabetes, cholesterolemia) in some users. The cause, degree, and impact are still under study. In fact, a joint study just completed by the Dept of Veterans Affairs, Boston Univ and the Univ of Chicago concluded that all atypical antipsychotic drugs are associated with diabetes risk but contradicted the Duke study with the finding that a lower rate of diabetes incidence is associated with Zyprexa than with other atypical antipsychotics on the market.
It's good to be informed and cautious about pharmaceuticals. However, the operative word is "informed" -- not propagandized. The side effects of psychotropic drugs, such as olanzapine, have been sensationalized in the media, and lawyers are having a field day with class action suits. Some of this activity might be valid, but some is sheer opportunism and manipulation of a misguided and manipulated public (and manipulation of the mentally ill).
The patient and consumer need to understand that no drug is without side effects. There is no perfect drug for the treatment of schizophrenia, bipolar disorder, etc.,(and I'm guessing you know all of this, Dr Bob) but we have come a long way in the past 40 years in developing safer, more effective drugs. The newer antipsychotic agents are less likely to cause motor defects, are less sedating than older agents and improve cognitive abilities and mood, whereas the older neuroleptics controlled the "positive symptoms" of schizophrenia (hallucinations, etc) but made patients into drooling, twitching zombies. Which is better? A zombie ever at risk for a breakthrough seizure or a patient whose schizophrenia is controlled and can think fairly clearly but who has to take special precautions for glycemic control?
A physician and patient must decide whether the benefits outweight the risks of a given medication. Further, each patient will react differently to a particular medication. This is why it is important to have a several different medications to choose from. Which brings me to another point -- which is health care access to a range of psychotropic agents. Some of the controversy and media play about supposed side effects of a given drug are related to competitive ploys among pharmaceutical manufacturers vying for who gets to be the "gold standard" -- the "preferred agent" on a health plan formulary -- when they should all be on the formulary, giving the physician and patient the leeway to make appropriate therapeutic choices.
> > Drugs for mental illness may be causing diabetes............04/11/2003
> > US FDA is confronted with evidence that a new generation of
> > big-selling drugs such as Zyprexa (Eli Lilly) for Schizophrenia &
> > other mental illnesses, cause life threatening diabetes symptoms.
> > Wall Street Journal, Anand & Burton
>
>
> Thanks for the heads-up.
>
> I am astounded at both the high incidence and the severity of this dysregulation of glucose associated with olanzapine (and other) atypical antipsychotics.
>
> Just use olanzapine and diabetes in any search engine, or in Medline. Astounding that this has not been better publicized, considering it has been nine months since researchers at Duke published a warning.
>
> Look at the incidence.....near 10%. And ketoacidosis. That's serious.
>
> Schizophr Res 2003 Jan 1;59(1):1-6
>
> New-onset diabetes and ketoacidosis with atypical antipsychotics.
>
> Wilson DR, D'Souza L, Sarkar N, Newton M, Hammond C.
>
> Department of Psychiatry, Creighton University School of Medicine, Omaha, NE 68131, USA. wilson@creighton.edu
>
> Information from the Ohio Department of Mental Health (ODMH) database was reviewed retrospectively to identify patients at the Cincinnati center treated with an atypical antipsychotic and who had also been evaluated or treated for diabetes mellitus. Blood glucose levels, glucose tolerance, or other evaluations of diabetes had been conducted in 14 of the 126 patients treated with atypical antipsychotics. In 11 of the 14, new-onset, acute, and marked glucose intolerance developed after treatment with clozapine, olanzapine or quetiapine. Of these, six patients required insulin therapy (four only transiently) and five patients developed diabetic ketoacidosis (DKA). Also, glucose metabolism was labile in all cases, and was transient in two cases with subsequent resolution despite on-going antipsychotic therapy. Certain atypical antipsychotics may be associated with new-onset glucose intolerance, including acute diabetes and ketoacidosis. Monitoring for changes in blood glucose levels in patients taking atypical antipsychotics may be indicated. More systematic study data are clearly needed.
>
>
Posted by Larry Hoover on August 29, 2003, at 12:39:44
In reply to Re: Serious side effect reported » Larry Hoover, posted by Med Editor on August 28, 2003, at 11:17:11
> Atypical antipsychotics in general may cause weight gain and its sequelae (diabetes, cholesterolemia) in some users. The cause, degree, and impact are still under study.
So, we shouldn't warn anyone? Those are not benign side-effects.
> In fact, a joint study just completed by the Dept of Veterans Affairs, Boston Univ and the Univ of Chicago concluded that all atypical antipsychotic drugs are associated with diabetes risk but contradicted the Duke study with the finding that a lower rate of diabetes incidence is associated with Zyprexa than with other atypical antipsychotics on the market.
If the study was just completed, then the results wouldn't have been available months ago, when the thread was active.
> It's good to be informed and cautious about pharmaceuticals. However, the operative word is "informed" -- not propagandized. The side effects of psychotropic drugs, such as olanzapine, have been sensationalized in the media, and lawyers are having a field day with class action suits.
Just what connection is there between my posting an abstract found on Medline/Pubmed, published in a peer-reviewed and much-respected medical journal, and the lay press?
> Some of this activity might be valid, but some is sheer opportunism and manipulation of a misguided and manipulated public (and manipulation of the mentally ill).
Are you preaching to the choir? Why have you chosen this posting for your reply? Your tone is baffling, and feels disrespectful.
Lar
This is the end of the thread.
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