Antipsychotics & increased risk of diabetes

[Anon54]

For over a year Ive been taking either Zyprexa or Seroquel off label for anxiety & insomnia only in fairly small doses. I plan to keep taking the Zyprexa but im worried about the increased chance of getting diabetes.

Does anyone know what percent extra you have of getting diabetes if ya taking a AP?
Does it differ from different APs?

If im less likely to develop it from Seroquel than I'll switch back to it.

ive been looking for links on the internet but cant find anything & Id appreciate some help finding information. Like I said i wanna know what percent increase it would be. If it's only like a 10% increase than i wont be to concerned but if it's like 5 times the chance of developing it I might have to consider quitting these meds.

Id like to also here from anyone on here who takes APs & has put on weight. Ive put on about 5kg over the last year which isnt really concerning me.

This is something that is worrying me to the point of considering quitting the APs & just dealing with the bad insomnia I have.

I'll keep searching for info on the net

 

[Cyanoide]

You didn't specify what doses of Seroquel you take. I took 100 mg for sleep for some 4 years. When I've spoken with different psychiatrists about this particular subject they all say the risk of diabetes mainly concerns people taking large doses (many hundreds of milligrams, even up to a gram daily) for many years. It's true quetiapine increases the risk of diabetes, but if your doses aren't huge (which I assume they aren't as you take it in small doses for insomnia like I did) I wouldn't be too worried.

Some sources say quetiapine increases the risk to get diabetes by nearly four times. That's pretty much. But those studies don't specify the doses, how long the medication have been taken, if there are other factors like an unhealthy diet, an existing pre-condition, other meds etc. So an exact percentage is impossible to give. It's only known that quetiapine does increase the risk for diabetes.

If you are worried about the side effects of quetiapine (rightfully so) like I was, I would recommend switching to mirtazapine for insomnia. It's extremely effective and I've never read or heard that it wouldn't be effective enough. It has a very heavy sedating initial effect but does not have the nasty side effects that antipsychotics have (they can be permanent).

 

[kokaino]

All antipsychotics tend to play around with your bodies sugar levels, usually increasing them. This is the main reason why many of the antipsychotics increase weight gain. I can see how long-term use of antipsychotics can or may lead to diabetes. This is especially true of olanzapine (Zyprexa), risperidone (Risperdal), and to a lesser extent, quetiapine (Seroquel) and aripiprazole (Abilify).

 

[Cyanoide]

To the OP, I really wouldn't recommend AP's for anxiety and insomnia. You should really consider mirtazapine. It's very effective for both anxiety and insomnia. The only strong side effect it has besides feeling extremely lethargic and spaced out the first week (until your receptors become desensitized to it and you actually feel more engergetic during daytime) is an absolutely crazy craving for anything sweet. But it's powerful initial sedative effect does not disappear by time. Most people gain weight because they can't control the cravings for anything sweet. It also has some water retention but it's harmless.

The first time I used it I gained 20 kg in a year! But I've used it after that and have learned to resist the cravings.

 

[Anon54]

well i take zyprexa.m only 5mg. it's prescribed up to 20mg so i guess i dont have to much to worry about. do u think its worth switching to seroquel just for the decreased weight change & risk of diabetes.
5mg of zyprexa would equal about 100mg of seroquel as AFAIK

& yeah i might give mirtazepine another try. but it gave me lucid dreams. Ive straightened myself out since than though. i dont drink or smoke. i only take codeine & valium

probelm is i actually LIKE Zyprexa. at the dose I take it helps me sleep. I dont feel goroggy in the morning & i seem a little more settled. it doesnt have a strange effect like mirtazepine. & i know i can take a larger dose incase of emergencies like come downs. & hangovers. & it works straight away to unlike ADs even though mirtazepine works pretty quick. zyprexa u can change dose & it instantly works.

So what's the real truth??
like I said i only take 5mg which isnt alot every night. Do u think I should be worried. it'll probably only slightly increase my risk of diabetes. right?

i just want someone to tell me im over worrying.

I might be trying effexor out soon cuz i liked tramadol...
do more ppl get success out of effexor or mirtazepine? (id like to know advice from someone who has tried both)

what do i have to worry about with taking mirtazepine. if its not diabetes its probably something else...

 

[Anon54]

sorry to bump this thread but im still really worried about the APs im taking
does mirtazepine increase ya change of getting diabetes as much as APs?

I only take 5mg zyprexa which isnt much or 100mg seroquel if im taking that. should i be to worried?
I might consider cutting down to 2.5mg zyprexa or 50mg seroquel cuz ive been alot more relazed since i quit smoking, drinking & cut down on caffeine

ive been happier on APs. they do slightly help with anxiety & help me sleep. Ive been taking them for a year & have only put on probably less than 5kg. but i havnt been doing alot of exercise

Does anyone know the what the increased chance of getting diabetes is when taking AP?
Im sure there's other ppl out there who take APs & are concerned & who have done research.

any help would be appreciated.

 

[effie]

Hi Anon.

It is difficult to give you an exact figure, because people vary - both in their predisposition to developing diabetes and in their response to antipsychotics. Genetics, lifestyle, antipsychotic, dose and duration of treatment all play a role.

A study here looking at a few antipsychotics, the risk is dose-dependent for both olanzapine and quetiapine - so as you are on low doses, that means your risk is reduced somewhat. For olanzapine, at 5-10mgs participants were 1.7 times more likely to develop diabetes than those not exposed to antipsychotic medication. At >10mgs this rose to 2.7. For quetiapine, at 50-150mgs participants were 1.2 times more likely (so not much higher than those not exposed) but at >150mgs this rose to 2.5 times. This is for patients taking that dose daily. It was primarily looking at schizophrenic patients, so a different demographic to you. Chronic schizophrenia can increase the risk of diabetes through lifestyle choices and lack of access to or engagement with healthcare, so the figures may be artificially increased by this.

Ignoring the effects of having schizophrenia on your risk, diabetes in antipsychotics develops for two reasons - one, antipsychotics are hyperglycaemic (increase your blood sugars) and diabetogenic (can assist the development of diabetes), and two, the can cause weight gain. This type of diabetes (Type II) has a few risk factors including weight and waist size (abdominal fat is more associated with developing it than fat elsewhere) so one thing you can do is keep a close eye on your weight and make sure you exercise and eat well. Controlling your blood pressure if it is high and not smoking will help your risk of developing cardiovascular and other vascular complications too.

In the UK patients on antipsychotics have bloods done every 6mths or so to check blood sugars and lipids and a few other things, and have their weight and sometimes waist size monitored.

Taking antipsychotics is all about weighing up the risks and benefits. Yes, there is an increased risk. However, if you keep your doses as low as possible and take steps to keep yourself healthy and your weight down then the risk is reduced. It depends how much benefit you have got from them. What does your doctor think?

Mirtazepine does not have the same risks, although it can increase your appetite and weight gain is associated with diabetes. It is less sedating at higher doses, so a low dose would be most appropriate. (Study looking at the effects on weight of various antidepressants)

This is a topic to discuss with your doctor really

 

[Cyanoide]

well i take zyprexa.m only 5mg. it's prescribed up to 20mg so i guess i dont have to much to worry about. do u think its worth switching to seroquel just for the decreased weight change & risk of diabetes.
5mg of zyprexa would equal about 100mg of seroquel as AFAIK

& yeah i might give mirtazepine another try. but it gave me lucid dreams. Ive straightened myself out since than though. i dont drink or smoke. i only take codeine & valium

probelm is i actually LIKE Zyprexa. at the dose I take it helps me sleep. I dont feel goroggy in the morning & i seem a little more settled. it doesnt have a strange effect like mirtazepine. & i know i can take a larger dose incase of emergencies like come downs. & hangovers. & it works straight away to unlike ADs even though mirtazepine works pretty quick. zyprexa u can change dose & it instantly works.

So what's the real truth??
like I said i only take 5mg which isnt alot every night. Do u think I should be worried. it'll probably only slightly increase my risk of diabetes. right?

i just want someone to tell me im over worrying.

I might be trying effexor out soon cuz i liked tramadol...
do more ppl get success out of effexor or mirtazepine? (id like to know advice from someone who has tried both)

what do i have to worry about with taking mirtazepine. if its not diabetes its probably something else...

I have extensive experience with both venlafaxine and mirtazapine. Venlafaxine is the AD that has given me the most side effects; nausea, loss of appetite and brain zaps while using it. The withdrawal from it was the worst I've had on any AD. Fortunately it only lasted for a week but I couldn't sleep, was sweating profusely, vomited and had the most severe brain zaps in my life. Some of the brain zaps were strong enough to cause blackouts for a few seconds followed by strong vertigo.

Mirtazapine has been very effective for me. Especially for sleep. It has little side effects apart from the increased appetite. But if you can handle the cravings (you learn to manage them by time) for anything sweet it's not a problem. It's indeed more sedating at lower doses than higher doses, although very high doses (60-120 mg but I very much doubt you'd ever use such doses) starts blocking dopamine and more or less knock you out. I sometimes use very high doses to get rid of stimulant comedowns and get sleep. Mirtazapine is one of the safest AD's, safer than SSRI's. It has very few dangerous interactions with any drugs (there are exceptions like DXM). It's also a peculiar AD because you can roll on MDMA or trip on psychedelics on it (it's known to actually potentiate psychedelics unlike SSRI's which do the opposite) and the risk of serotonin syndrome is slim. It can actually be used to treat serotonin syndrome due to it being a 5-HT receptor antagonist. E.g. SSRI's and 5-HTP can cause serotonin syndrome. Mirtazapine can safely be combined with 5-HTP. I'm not saying you should mix them or advocate taking the drugs I mentioned, I just wanted to illuistrate mirtazapine's high safety profile.