Atypical antipsychotics, insulin resistance and weight; a meta-analysis of healthy volunteer studies.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of clinical trials
PubMed 29325867 · doi:10.1016/j.pnpbp.2018.01.004
What was done
The authors conducted a systematic review and meta-analysis of trials assessing the effects of atypical antipsychotics on insulin sensitivity and body weight in healthy volunteers. Subgroup analyses and meta-regression were performed to determine whether insulin resistance occurs independently of weight gain and how effects vary by treatment duration.
What was found
Atypical antipsychotics significantly reduced insulin sensitivity (standardized mean difference = -0.437, p < 0.001) and increased weight (standardized mean difference = 0.591, p < 0.001). Decreases in insulin sensitivity were observed in multi-dose studies lasting less than 13 days and were not dependent on weight gain, whereas weight gain was detected in studies lasting 14 days or longer (up to 28 days).
Why it matters
These findings show that metabolic dysregulation from atypical antipsychotics is a direct drug effect rather than a consequence of underlying psychiatric disease or secondary weight gain.
Limits
The abstract does not state the number of included studies or participants. The maximum intervention length was 28 days, limiting conclusions about long-term metabolic outcomes, and specific drug differences are not reported in the abstract.
Cited by
- supports Antipsychotic drugs used to treat bipolar and schizophrenia cause patients to overeat and develop diabetes or insulin resistance.