A large-scale study conducted by Dutch scientists demonstrated a significant increase in the incidence of type 2 diabetes among children and adolescents after starting antipsychotic medication. According to the researchers' calculations, every five years, nine additional cases were recorded per ten thousand residents.
Risks even with short-term treatment
It was found that an increased risk of developing diabetes was observed even after the treatment with antipsychotic drugs was brief. These findings were published in JAMA Network Open.
Use of antipsychotics in adolescents
Antipsychotic drugs are widely used worldwide to treat various conditions in children and adolescents, including autism spectrum disorders, attention deficit hyperactivity disorder, as well as anxiety disorders and sleep problems. Existing observational studies and meta-analyses already indicate an increased likelihood of developing type 2 diabetes when taking these medications during childhood and adolescence.
Highest risk and uncertainties
Patients taking olanzapine and clozapine are at the highest risk. Nevertheless, many clinical aspects of this relationship remain unclear in most scientific works. In particular, it is not determined at what exact point the excess risk arises and whether it persists after discontinuing medication.
Study methodology
A team of scientists led by Ravish Nilish Gangapersad from Erasmus University Rotterdam studied the dynamics of the annual prevalence of type 2 diabetes among children and adolescents aged zero to nineteen who were receiving antipsychotic drugs. The study included 89,991 individuals who had been prescribed such medications at least once between 2006 and 2022. The average age of starting the medication was 13.6 years.
Trend in disease incidence
A significant increase in the prevalence of type 2 diabetes became noticeable as early as the first year of antipsychotic drug use. A statistically significant increase was recorded precisely during this period. Starting from the second year of therapy, the rates for women consistently exceeded those for men. By the fifth year, the difference in risk reached 16.48 cases per 10 thousand people in women and 5.5 cases per 10 thousand people in men (p = 0.008).
Final conclusions and recommendations
Sensitivity analysis and additional adjustments considering the use of other medications and socioeconomic factors confirmed the initial findings. In a comprehensive analysis, the difference in risk was 4 cases per 10 thousand population during the first year of use and 11.45 cases per 10 thousand people during the fifth year of observation. The authors believe that this data may be useful in clinical practice when prescribing antipsychotic drugs. Female adolescents over 12 years old constitute a particularly high-risk group, as even short-term exposure to the drugs can negatively affect metabolic processes, requiring an extremely cautious approach to psychopharmacotherapy in this age group.
