RESOUR> [NetGold] MEDICAL: DISEASES: DIABETES : PSYCHOLOGY: DISORDERS: SHIZOPHRENIA:

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Net Happenings - From Educational CyberPlayGround
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Date: Sat, 31 Jan 2004 11:43:45 -0500 (EST)
From: David P. Dillard <jwne@xxxxxxxxxx>
Reply-To: NetGold@xxxxxxxxxxxxxxx
To: NetGold <NetGold@xxxxxxxxxxxxxxx>
Subject: [NetGold] MEDICAL: DISEASES: DIABETES : PSYCHOLOGY: DISORDERS:
     SCHIZOPHRENIA: Risk Factors for Diabetes in People with Schizophrenia 
Mirror Those of General Population

Risk Factors for Diabetes in People with Schizophrenia Mirror Those of
General Population

Many People with Schizophrenia who Developed Diabetes During Treatment
with Antipsychotics Tended to Be Predisposed to Diabetes
May 20, 2003
Source: Eli Lilly Press Release. Eli Lilly is the manufacturer of Zyprexa.
<http://www.healthyplace.com/Communities/Thought_Disorders/
schizo/news/zyprexa_diabetes_3.htm>

A shorter URL for the above link:

<http://snipurl.com/478x>

The risk factors for diabetes in people who develop diabetes while
undergoing treatment for schizophrenia are similar to those of the general
population according to the findings of a retrospective analysis presented
today at the annual meeting of the American Psychiatric Association.

"The data indicate that a high percentage of these schizophrenic patients
who developed diabetes during antipsychotic treatment had a predisposition
for diabetes prior to their treatment for schizophrenia," explained Dr.
John Buse, Director of the Diabetes Care Center at the University of North
Caro-lina School of Medicine. "This preliminary analysis underscores the
importance of physicians being attentive to the known risk factors for
diabetes - older age, high blood pressure, history of abnormal glucose
tolerance and obesity - in their patients with schizophrenia."

About the Study

Research over several decades has demonstrated that people with
schizophrenia have as much as two to four times higher risk of diabetes
than the general population. (1-4) While the reasons for this increased
risk are unclear, the objective of this study was to characterize risk
factors for diabetes for people with schizophrenia.

The researchers studied the prevalence of well established diabetes risk
factors (5) in a database of more than 5,000 people with schizophrenia
compiled from 24 clinical research studies, conducted by Eli Lilly and
Company, of patients taking widely prescribed antipsychotic medications
including olanzapine, haloperidol (Haldol), risperidone (Risperdal)and
clozapine (Clozaril), as well as placebo.

--------------------------------------------------------------

The full press release may be read at the URL above.  One may however want
to see what the medical literature has to say about this issue.  Here are
seven on topic articles.

Atypical antipsychotics cause diabetes mellitus in schizophrenia?
[Editorial] Reactions Weekly. 853:3, May 26, 2001.

Wirshing DA. Spellberg BJ. Erhart SM. Marder SR. Wirshing WC. Novel
antipsychotics and new onset diabetes. [Case Reports. Journal Article]
Biological Psychiatry. 44(8):778-83, 1998 Oct 15

Waldman, Jeffrey C; Yaren, Stanley. Atypical antipsychotics and glycemia:
A case report. [Peer Reviewed Journal] Canadian Journal of Psychiatry -
Revue Canadienne de Psychiatrie. Vol 47(7) Sep 2002, 686-687. Canadian
Psychiatric Assn, Canada

Casey, Daniel E. Atypical antipsychotics: Enhancing healthy outcomes.
[Journal Article] Archives of Psychiatric Nursing. Vol 16(3,Suppl1) Jun
2002

Meltzer, Herbert Y. Putting metabolic side effects into perspective: Risks
versus benefits of atypical antipsychotics. [Journal Article] Journal of
Clinical Psychiatry. Vol 62(Suppl27) 2001, 35-39. Physicians Postgraduate
Press

Here are several additional articles that either have bibliographies or
are review articles:

Dolder, Christian R. PharmD. Lacro, Jonathan P. PharmD, and. Jeste, Dilip
V. MD. Adherence to Antipsychotic and Nonpsychiatric Medications in
Middle-Aged and Older Patients With Psychotic Disorders. [Article]
Psychosomatic Medicine. 65(1):156-162, January/February 2003

Seaburg HL. McLendon BM. Doraiswamy PM. Olanzapine-associated severe
hyperglycemia, ketonuria, and acidosis: case report and review of
literature. [Review] [20 refs] [Case Reports. Journal Article. Review.
Review of Reported Cases] Pharmacotherapy. 21(11):1448-54, 2001 Nov.

Dwyer DS. Bradley RJ. Kablinger AS. Freeman AM 3rd. Glucose metabolism in
relation to schizophrenia and antipsychotic drug treatment.[see comment].
[Review] [116 refs] [Journal Article. Review. Review, Tutorial] Annals of
Clinical Psychiatry. 13(2):103-13, 2001 Jun.

--------------------------------------------------------------

In addition, here is some additional content on this subject from the web.

from
New York Times
May 20, 2003
Leading Drugs for Psychosis Come Under New Scrutiny
By ERICA GOODE
<http://www.biopsychiatry.com/misc/antipsychotic.html>

They were billed as near wonder drugs, much safer and more effective in
treating schizophrenia than anything that had come before.

For many years, it seemed that the excitement was fully warranted.

There were remarkable stories of recovery. And the new generation of
antipsychotic drugs, called atypicals, seemed to have few of the side
effects commonly seen with high doses of older medications for psychosis.

The drugs appeared so successful that doctors began prescribing them for
other things, not only for other psychotic illnesses, like manic
depression, but also for Alzheimer's, personality disorders and
nonpsychotic depression, and for conduct disorder and severe aggression in
children. Sales of the drugs soared. More than 15 million prescriptions
were written last year for the two leading drugs alone, Zyprexa and
Risperdal, industry figures show.

But 14 years after the first of the drugs entered the market, researchers
are questioning whether they are quite as miraculous - or benign - as
originally advertised.

--------------------------------------------------------------

 >From Medscape General Medicine
Original Article
Rate of New-Onset Diabetes Among Patients Treated With Atypical or
Conventional Antipsychotic Medications for Schizophrenia
Posted 01/20/2004
Daniel A. Ollendorf, MPH; Amie T. Joyce, MPH; Malcolm Rucker, MS
<http://www.medscape.com/viewarticle/466800?rss>
[Free Registration Required to View Medscape Content]

Conclusions: Patients with schizophrenia treated with atypical
antipsychotics had a moderately increased risk of DM relative to those
treated with conventional antipsychotics, as measured by Cox proportional
hazards models; such risk was not significantly different among patients
treated with individual atypical medications.

Medscape Home Page
<http://www.medscape.com/>

--------------------------------------------------------------

Diabetic-Lifestyle What's Hot informs and stimulates with monthly in-depth
articles on diabetic health topics. Diabetic-Lifestyle offers recipes,
menus, medical updates, entertaining, travel - practical information to
enhance life while managing diabetes on a daily basis. - Home

Diabetes in the Mentally Ill: Are Antipsychotics Involved?
<http://www.diabetic-lifestyle.com/articles/sep01_whats_1.htm>

--------------------------------------------------------------

Most Atypical Antipsychotics
Tied to Increase in Diabetes
August 22, 2003
<http://www.healthyplace.com/Communities/Thought_Disorders/
schizo/news/diabetes_antipsychotics_2.htm>

A shorter URL for the above link:

<http://snipurl.com/478v>

FDA Seeks Diabetes Warning
on All Antipsychotic Drugs
Sept. 18, 2003
<http://www.healthyplace.com/Communities/Thought_Disorders/
schizo/news/diabetes_antipsychotics_3.htm>

A shorter URL for the above link:

<http://snipurl.com/478u>

--------------------------------------------------------------

The Journal of Applied Research in Clinical and Experimental Therapeutics
Risk of Diabetes for Individuals with Schizophrenia Treated with
Antipsychotics
Zhongyun Zhao, PhD
Sandra L. Tunis, PhD
Danielle L. Loosbrock, MHA
Outcomes Research, Eli Lilly & Company, Indianapolis, Indiana
<http://www.jrnlappliedresearch.com/articles/Vol3Iss3/Zhao.htm>

--------------------------------------------------------------

Alliance for Human Research Protection
AHRP is a national network of lay people and professionals dedicated to
advancing responsible and ethical medical research practices, to ensure
that the human rights, dignity and welfare of human subjects are
protected, and to minimize the risks associated with such endeavors.

Schizophrenia drugs increase diabetes risk
Fri, 29 Aug 2003
<http://www.researchprotection.org/infomail/03/08/29a.html>

A large scale study by the Veterans Administration corroborates a body of
evidence demonstrating that the much touted "improved" newer drugs for the
treatment of schizophrenia--Zyprexa, Risperdal, Seroquesl-- are
precipitating the onset of diabetes at alarming rates-- especially among
younger patients.

Things to consider:

1. "Diabetes affects virtually every tissue of the body. Life expectancy
for people with diabetes averages 10-15 years less than that of the
general population."

Diabetes Research Working Group. 1999. Diabetes mortality rapidly on the
rise. Report. Jocelyn Diabetes Center. online at:
http://www.joslin.harvard.edu/news/dcongress.shtml

2. Until the introduction of the atypical antipsychotics, clozapine
(Clozaril) and olanzapine (Zyprexa), the condition was rare in children
and adolescents. At the August 2001 meeting of American Psychiatric
Association, Dr. Frank J. Ayd, an internationally renowned
psychopharmacology expert, and editor of the International Drug Therapy
Newsletter, presented findings of his review of the literature for
atypical antipsychotics. He found a "startling" association between
initiation of treatment with olanzapine and new-onset diabetes in
adolescents:

"New-onset diabetes after antipsychotic treatment initiation is startling,
since the use of atypical antipsychotics has become the first line of
treatment for schizophrenia. Twenty-six case reports were analyzed, of
which 14 reports of diabetes, diabetic ketoacidosis (DKA) or worsening
diabetic blood glucose control after initiation of olanzapine were found.
Five (36%) of these patients developed DKA. Seventy-nine percent of the
patients were compelled to discontinue their antipsychotic. Eighteen
percent of the patients who discontinued their medications required
long-term insulin; 18% required long-term oral hyperglycemic treatment."

Ayd, FJ. 2001. Research Presented at Annual Meeting. Psychiatric Times
(August ) Vol. 18. online at: http://www.psychiatrictimes.com/p010823.html

--------------------------------------------------------------

ALLIANCE FOR HUMAN RESEARCH PROTECTION (AHRP)
<http://www.researchprotection.org>
Antipsychotics and Diabetes

It is astounding to AHRP that the FDA has approved a clinical trial that
exposes teenagers-- who are not even diagnosed with schizophrenia-- to a
drug that puts them at risk of diabetes. The trial is being conducted at
Yale University. [See, AHRP complaint filed with the federal Office of
Human Research Protection at:
<http://www.researchprotection.org/Initiatives/YaleComplaint.html>

--------------------------------------------------------------

[PDF] 3 Schizophrenia Drugs May Raise Diabetes Risk, Study Says
File Format: PDF/Adobe Acrobat
preventing relapse in patients with schizophrenia and may ... the two
leading atypical antipsychotics, according to ... found higher rates of
diabetes and hyperglycemia ...
<http://www.dukehealth.org/mental_health/ Schizophrenia_Drugs.pdf>

--------------------------------------------------------------

The full content may be viewed at all of the URLs provided above.


Sincerely,
David Dillard
Temple University
(215) 204 - 4584
jwne@xxxxxxxxxxxxxxxx
<http://groups.yahoo.com/group/NetGold/>
<http://www.edu-cyberpg.com/ringleaders/davidd.html>
<http://www.kovacs.com/medref-l/medref-l.html>

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