Antipsychotics Risky for Elderly With Diabetes

Drugs Used for Dementia Symptoms May Raise Risk of Hyperglycemia in Older People With Diabetes:

A class of drugs used to treat dementia symptoms and other mental ailments in the elderly may be dangerous for those with diabetes.

A new study shows that older people with diabetes are more likely to be hospitalized for hyperglycemia (elevated blood sugar levels) after beginning treatment with antipsychotic drugs.

Researchers say antipsychotic drugs are being increasingly prescribed to treat dementia and other behavioral problems in the elderly.

These drugs are known to carry a number of risks, including an increased risk of stroke, diabetes, and Parkinson’s disease-like symptoms. There have also been some reports of hyperglycemia after beginning therapy with antipsychotics, but researchers say few studies have examined these risks in older people as well as in elderly with pre-existing diabetes.

Antipsychotic Drug Risk

The study, published in the Archives of Internal Medicine, looked at the risk of hospitalization for hyperglycemia in older adults with diabetes between 2002 and 2006 in Canada.

Of the 13,817 people studied, 11% were hospitalized for hyperglycemia, diabetic ketoacidosis, or hyperosmolar coma.

Researchers found that those who were taking an antipsychotic were about one-and-a-half times more likely to be hospitalized for hyperglycemia than those who stopped taking the medications at least 180 days prior. The risk was highest among those who had just started taking an antipsychotic drug.

The results showed the risk of hyperglycemia was increased in elderly people with diabetes regardless of the type of antipsychotic drug they used.

Antipsychotics are divided into two groups, older or typical antipsychotics, such as Haldol, and atypical or second-generation antipsychotic drugs, such as Zyprexa, Seroquel, and Risperdal.

Although further studies are needed to confirm these results, researchers say the study suggests that the start of antipsychotic therapy is a critical period in which older adults are particularly vulnerable to hyperglycemia.

“In the meantime, other options to manage behavioral symptoms of dementia should be considered among older persons with diabetes,” write 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.