Original Report

Atypical antipsychotic drugs and diabetes mellitus in a large outpatient population: a retrospective cohort study†

  1. Truls Østbye MD, PhD1,*,
  2. Lesley H. Curtis PhD3,
  3. Leah E. Masselink BA3,
  4. Steve Hutchison PhD4,
  5. Alan Wright MD5,
  6. Peter E. Dans MD5,
  7. Kevin A. Schulman MD3,
  8. Ranga R. Krishnan MB, ChB2

Article first published online: 16 SEP 2004

DOI: 10.1002/pds.1016

Issue

Pharmacoepidemiology and Drug Safety

Pharmacoepidemiology and Drug Safety

Volume 14, Issue 6, pages 407–415, June 2005

Additional Information

How to Cite

Østbye, T., Curtis, L. H., Masselink, L. E., Hutchison, S., Wright, A., Dans, P. E., Schulman, K. A. and Krishnan, R. R. (2005), Atypical antipsychotic drugs and diabetes mellitus in a large outpatient population: a retrospective cohort study. Pharmacoepidemiology and Drug Safety, 14: 407–415. doi: 10.1002/pds.1016

Author Information

  1. 1

    Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA

  2. 2

    Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA

  3. 3

    Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA

  4. 4

    AdvancePCS, Scottsdale, AR, USA

  5. 5

    AdvancePCS Clinical Services, Hunt Valley, MD, USA

*Department of Community and Family Medicine, Box 2914, Duke University Medical Center, Durham, NC 27710, USA.

  1. †

    Conflict of interest was declared—R. R. K. has been paid as a consultant by a company with a vested interest in the product being studied, on issues unrelated to the product being studied. The sponsor of this project had the right of commenting but the authors retained the right to accept or reject comments or suggestions.

Publication History

  1. Issue published online: 27 MAY 2005
  2. Article first published online: 16 SEP 2004
  3. Manuscript Accepted: 27 JUL 2004
  4. Manuscript Revised: 19 JUL 2004
  5. Manuscript Received: 17 MAR 2004

Funded by

  • Duke University and Eli Lilly and Company, Indianapolis, IN
  • Centers for Education and Research on Therapeutics (CERTs) cooperative agreement (to TØ, LHC, AW, PED and KAS) between the Agency for Healthcare Research and Quality, Rockville, MD, and the University of Arizona Health Sciences Center, Tucson. Grant Number: U18 HS10385

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Keywords:

  • antipsychotic agents;
  • cohort studies;
  • diabetes mellitus;
  • pharmaceutical services, insurance;
  • pharmacoepidemiology;
  • prescriptions, drug

Abstract

Purpose

Previous research has suggested an association between use of atypical antipsychotics and onset of diabetes mellitus. We sought to compare the incidence of new onset diabetes among patients receiving atypical antipsychotics, traditional antipsychotics or antidepressants.

Methods

Retrospective cohort study of outpatients with claims for atypical antipsychotics (n = 10 265) compared to controls with claims for traditional antipsychotics (n = 4607), antidepressants (n = 60 856) or antibiotics (n = 59 878) in the administrative claims database of a large pharmaceutical benefit manager between June 2000 and May 2002. Main outcome measures were adjusted and unadjusted incidence rates of diabetes (new cases per 1000 per year) in a 12-month period, as measured using new prescriptions for antidiabetic drugs after a 6-month lead-in period.

Results

Annual unadjusted incidence rates of diabetes (new cases per 1000 per year) were 7.5 for atypical antipsychotics, 11.3 for traditional antipsychotics, 7.8 for antidepressants and 5.1 for antibiotics. In multivariable analyses, age, male sex and Chronic Disease Score were associated with greater odds of diabetes onset. There were no statistically significant differences in outcome between the atypical antipsychotic, traditional antipsychotic and antidepressant groups. Multivariable comparisons among specific agents showed increased odds of diabetes for clozapine, olanzapine, ziprasidone and thioridazine (relative to risperidone), but these comparisons did not reach statistical significance.

Conclusions

In a large prescription claims database, outpatients taking atypical antipsychotics did not have higher rates of diabetes onset, compared to subjects taking traditional antipsychotics or antidepressants. Copyright © 2004 John Wiley & Sons, Ltd.

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