Diabetes Risk for Children, Young Adults on Second-Generation Antipsychotics

Type 2 diabetes is greater with second-generation antipsychotics than with non-second-generation antipsychotic psychotropic medications for patients aged 6 to 25 years.

The risk for type 2 diabetes (T2DM) is greater with second-generation antipsychotics (SGAs) than with non-SGA psychotropic medications for patients aged 6 to 25 years, researchers report in the Journal of Child and Adolescent Psychopharmacology.

Their study included 45,289 SGA users and 932,336 non-SGA psychotropic users and showed a 1.7 times higher hazard for developing T2DM among the SGA users (hazard ratio, 1.71; 95% CI, 1.33-2.20). The median time to a diagnosis of diabetes or prescription of an antidiabetic medication was less than 1 year. 

The retrospective study had a new-user design: children and young adults in the age range were entered after a 180 nonpsychotropic drug period, when they filled a new prescription for a SGA or a non-SGA psychotropic (antidepressant, anxiolytic, hypnotic, or mood stabilizer) between July 1, 2009, and December 30, 2013.

The young whose records were examined were included if they had no history of diabetes or of taking an antidiabetic medication within the 180-day period preceding the first prescription for an SGA or non-SGA psychotropic. Nor could they have a history of conditions at baseline that tend to be associated with development of diabetes.

Patients chronically receiving steroids, a risk factor for T2DM, were excluded if they used steroids within 60 days of getting a new prescription for an antipsychotic. All patients had a mental healthy diagnosis at baseline.

A total of 141 of the SGA users, who were propensity score matched to the non-SGA psychotropic users at a 1:1 ratio, developed T2DM (33 cases per 10,000 patient-years). Of the non-SGA users, 110 developed T2DM (18 cases per 10,000 patient-years).

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The researchers point out that the risk should be taken in account when determining whether a child or young adult should be prescribed a SGA.


Dr Xing’s education was supported by the 2014 to 2016 University of Illinois in Chicago/Takeda Pharmaceuticals USA, Inc. Fellowship in Medication Adherence Fellowship. Takeda Pharmaceuticals had no input or influence on design, results, or interpretation of this study.


Xing S, Lee TA. Increased risk of diabetes among 6 to 20 year olds using second generation antipsychotics [published online August 11, 2017]. J Child Adolescent Psychopharmacol. doi: 10.1089/cap.2016.0072.