Postgrad Med. 2003 Dec;114(6 Suppl Managing Metabolic):59-71. doi: 10.3810/pgm.12.2003.suppl31.181.
This article reviews case reports and cohort studies involving antipsychotics and diabetes. The first part describes early case reports of new-onset glucose intolerance associated with chlorpromazine and lithium. The rest of the article presents findings from a literature review concerning atypical antipsychotics and the development of de novo diabetes mellitus or the exacerbation of already diagnosed diabetes mellitus. Evidence is presented from 3 types of sources: 1) case reports, 2) pharmacovigilance studies, and 3) retrospective reviews of treatment databases. The strengths and limitations of each of these methods are also discussed. Detailed tables are provided summarizing the findings from all 3 types of studies concerning all the currently available atypical antipsychotics. A discussion is included on the evidence for an association between atypical antipsychotics and an increased risk for diabetes mellitus. Further research is recommended to address important unanswered questions, such as what factors may confer an increased risk for patients with schizophrenia to develop diabetes.
本文回顾了涉及抗精神病药物与糖尿病的病例报告和队列研究。第一部分描述了与氯丙嗪和锂相关的新发葡萄糖不耐受的早期病例报告。文章其余部分介绍了一项关于非典型抗精神病药物与新发糖尿病或已确诊糖尿病病情加重的文献综述结果。证据来自3种类型的来源：1）病例报告，2）药物警戒研究，以及3）治疗数据库的回顾性分析。还讨论了每种方法的优势和局限性。提供了详细的表格，总结了所有3种类型研究中关于所有目前可用非典型抗精神病药物的结果。文中还讨论了非典型抗精神病药物与糖尿病风险增加之间关联的证据。建议进一步开展研究，以解决重要的未解答问题，例如哪些因素可能使精神分裂症患者患糖尿病的风险增加。
