The drug, olanzapine (trade name Zyprexa), belongs to a relatively new family of medications called atypical antipsychotics, which are used to treat schizophrenia, paranoia and manic-depressive disorders. Other drugs in this class include clozapine, risperidone, quetiapine and ziprasidone.
The researchers found metabolic abnormalities ranging from mild blood sugar problems to diabetic ketoacidosis and coma in patients who had been prescribed olanzapine, most of whom were otherwise not known to be diabetic. Diabetic ketoacidosis (DKA) is a serious condition in which a person experiences an extreme rise in blood glucose level coupled with a severe lack of insulin, which results in symptoms such as nausea, vomiting, stomach pain and rapid breathing. Untreated, DKA can lead to coma and even death.
"While our report does not prove a causal relationship between the drug and diabetes, doctors should be aware of such potentially adverse effects," said P. Murali Doraiswamy, M.D., a psychiatrist at Duke and co-author of the study. "We've found cases where patients had some very serious problems associated with olanzapine, and at least 23 of them died."
The findings appear in the July 2, 2002 issue of Pharmacotherapy. The research was self-supported by the authors.
Doraiswamy and Elizabeth A. Koller, M.D., lead author of the study and a medical officer at the FDA, queried the FDA MedWatch Drug Surveillance System, MEDLINE (a biomedical database) and selected abstracts from national psychiatry meetings over a period of eight years and identified 289 cases of diabetes in patients who had been given olanzapine. Of the 289 cases of diabetes linked to the use of olanzapine, 225 were
Contact: Tracey Koepke
Duke University Medical Center