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Antipsych Drugs Risky for Elderly Diabetics

Jul 30, 2009 | Parker Waichman LLP Antipsychotic drugs used to treat older people for dementia symptoms and other mental ailments could be risky for diabetics. Earlier this year, we wrote that some newer, atypical, or second-generation, antipsychotic medications were found to have two serious adverse reactions.  The drugs were found to lower so-called “good” cholesterol and cause weight gain in older Alzheimer patients.

The new study reveals that that elderly diabetics are likelier to be hospitalized for hyperglycemia—high blood sugar levels—following antipsychotic drug treatment, said WebMD.

Last year we wrote that antipsychotic drug use to reduce symptoms of agitation, aggression, and violence in dementia patients was on the rise, as could be seen in soaring sales of antipsychotics like Risperdal, Seroquel, and Zyprexa.  These drugs experienced a $4 billion dollar increase in sales since 2000 for a total of $13.1 billion in 2007, due, in part, to an increase in such prescriptions in nursing homes.  As a matter-of, researchers estimated that nearly 30 percent of all nursing home patients have received antipsychotic drugs at one time or another. WebMD also just noted that researchers have found that antipsychotic prescribing habits are on the rise for the treatment of dementia and behavioral issues in the senior population.

As WebMD pointed out, antipsychotics can carry dangerous risks that include stroke, diabetes, and symptoms similar to those found in Parkinson’s disease, as well as hyperglycemia. The recent study, which examined risks associated with hospitalizations linked with hyperglycemia in elderly diabetics (13,817 patients during 2002-2006), was published in the Archives of Internal Medicine, said WebMD. Eleven percent of those studied required hospitalization for hyperglycemia, diabetic ketoacidosis, or hyperosmolar coma.

According to WebMD, the researchers discovered that patients on an antipsychotic were approximately one-and-a-half times likelier to require hospitalization for hyperglycemia versus patients who stopped antipsychotic use 180 days prior, with the greatest risk seen in more recent users.

According to the researchers, said WebMD, early antipsychotic therapy is a significant juncture of hyperglycemia vulnerability in the elderly, said WebMD, pointing to a need for further research. “In the meantime, other options to manage behavioral symptoms of dementia should be considered among older persons with diabetes,” wrote researcher Lorraine L. Lipscombe, MD, MSc, of the Institute for Clinical Evaluative Sciences, University of Toronto and Women’s College Research Institute at Women’s College Hospital in Toronto, Ontario, and colleagues, quoted WebMD.

WebMD explained that antipsychotics fall into one of two groups, the more traditional, so-called “typical” antipsychotics such as Haldol, and the atypical or second-generation antipsychotic drugs that include Zyprexa, Seroquel, and Risperdal.

In April we wrote that earlier this year, the New England Journal of Medicine released a study that found some atypicals double the risk of heart failure and death, raising questions over emerging claims that atypicals are safer than older generation antipsychotics.  Atypicals are used to treat schizophrenia and other mental problems, but are also widely used off-label to treat dementia and childhood hyperactivity.  Many experts and patient advocates have called for a halt to such practices.


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