Diabetes Associated With Atypical Antipsychotic Treatment may Be Severe But Reversible: Case Report
Abstract
Objective: To draw attention to severe presentations of atypical neuroleptic related diabetes and to document that a marked degree of remission can take place after drug withdrawal. Method: We describe two patients who presented with diabetic ketoacidosis after treatment with quetiapine and risperidone, respectively. Results: Both patients were negative for islet cell antibodies. They both required treatment with insulin, one in very high dosage, but their insulin requirements fell progressively after the atypical antipsychotic was withdrawn. After several months, neither patient required antidiabetic treatment. Conclusions: Atypical antipsychotic-induced diabetes does not always take a “type 2” presentation in which weight gain and insulin resistance are implicated. Sometimes the presentation is with diabetic ketoacidosis, requiring insulin treatment, which can nevertheless be reversible.
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Prior case reports and a few studies suggest that at least some weight can be lost after discontinuation of antipsychotic medication.
“Peculiarly, little research has been focusing on the potential reversibility of weight gain if the antipsychotic drug is reduced, discontinued, or switched to an agent with lower obesogenic properties, but case reports (13, 14) and a few studies of patients with intellectual disabilities and children with bipolar disorder (15) suggest that at least some weight can be lost after discontinuation.”
From Reversibility of Antipsychotic-Induced Weight Gain: A Systematic Review and Meta-Analysis (2021) · cites this paper as [13]
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Reversibility of Antipsychotic-Induced Weight Gain: A Systematic Review and Meta-Analysis
Speyer, H., Westergaard, C., Albert, N., Karlsen, M., Stürup, A. E., Nordentoft, M., & Krogh, J. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.577919 · Cited by 44 · see citing works
- Authors
- Dibben, C. R. M., Kalavalapalli, S. S., Linnington, H. E. J., Hynes, F. A., Dinneen, S. F., Adler, A. I., & McKenna, P. J.
- Affiliations
- Fulbourn Hospital (GB)
- Salford Royal Hospital (GB)
- Addenbrooke's Hospital (GB)
- Corresponding author
- Dibben, C. R. M.
- Venue
- The International Journal of Psychiatry in Medicine
- Publisher
- SAGE Publications
- Published
- 2005-09
- Volume
- 35
- Issue
- 3
- Pages
- 307-311
- ISSN
- 0033-278X (ISSN-L)
- 0091-2174
- 1541-3527
- OpenAlex
- W2049762236
- Cited by
- 21
- References
- 0
- Citations by year
- 2025: 1 · 2021: 1 · 2017: 2 · 2015: 2 · 2014: 1 · 2013: 2 · 2012: 1
- FWCI
- 1.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The International Journal of Psychiatry in Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- quetiapine, risperidone, diabetic ketoacidosis, drug-induced diabetes, insulin requirement, drug withdrawal, islet cell antibodies, insulin resistance
- MeSH terms
- Quetiapine Fumarate, Adult, Diabetes Mellitus, Type 2, Dibenzothiazepines, Female, Humans, Hypoglycemic Agents, Male, Metformin, Middle Aged, Schizophrenia, Severity of Illness Index, Antipsychotic Agents, Risperidone
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