Antipsychotic medication information, diabetes side effects, influence on blood sugar levels, safety, dangers and warnings, toxicity
October 20 2016

Antipsychotics are pharmaceutical drugs used to treat certain mental disorders but they have side effects which include diabetes or an increase in blood sugar levels. Some studies indicate that if they are used every other day they can maintain their effectiveness while reducing adverse reactions which are quite common. The idea is to use a low a dose as possible.

Nerve cell damage protection with natural substances
Ashwagandha herbal product may be helpful in reducing nerve cell damage and CNS side effects from antipsychotic medications.
Other supplements, vitamins, and herbs are being evaluated for this purpose. Perhaps other herbal products with antioxidant benefits could help protect the nerves from damage.

Effect on blood sugar and diabetes
The use of atypical antipsychotics has been associated with disruption of the glucose metabolism and therefore with causing diabetes. The binding of various essential receptors or transporters in essential body tissues, adipose tissue, pancreatic tissue and liver and skeletal muscle tissue can cause disruption of the glucose metabolism. Clozapine and olanzapine cause weight gain and diabetes mellitus, whereas aripiprazole and ziprasidone have much less disruptive clinical profiles. The most significant risk factor for adiposity seems to be strong blocking of histaminergic receptors. An agonistic activity on serotonergic-1a receptors, with a very low affinity for muscarinergic-3 receptors, might protect against the development of diabetes.

Increased risk for disease, metabolic syndrome
Metabolic syndrome and other cardiovascular risk factors are highly prevalent in people with schizophrenia. Patients are at risk for premature mortality and overall have limited access to physical health care. In part these cardio-metabolic risk factors are attributable to unhealthy lifestyle, including poor diet and sedentary behavior. But over recent years it has become apparent that antipsychotic agents can have a negative impact on some of the modifiable risk factors.

Metabolic considerations in the use of antipsychotic medications: a review of recent evidence.
Journal Clinical Psychiatry 2007.
Compared with the general population, persons with schizophrenia have up to a 20% shorter lifespan, with cardiovascular disease as the leading cause of death. In addition, persons with schizophrenia have increased prevalence of the metabolic syndrome (obesity, insulin resistance, dyslipidemia, impaired glucose tolerance, and hypertension), increased prevalence of risk factors such as smoking, poverty, and poor nutrition, and reduced access to medical care. Results from the recent Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) provide further evidence of the metabolic risk associated with different atypical antipsychotic medications. Based on this study and a growing number of other randomized clinical trials, clozapine and olanzapine treatment can produce substantial mean changes in weight and an increased risk of associated metabolic disturbances. Risperidone and quetiapine treatment can produce intermediate changes in mean weight in comparison to treatment with other atypical antipsychotic medications, with discrepant results with respect to metabolic risk. Aripiprazole and ziprasidone treatment induced the lowest mean changes in weight gain and had no effect on risk for adverse metabolic changes, among currently available atypical agents.

Antipsychotic medication in the treatment of delirium: a systematic review.
J Clin Psychiatry. 2007.
The purpose of this study was to systematically evaluate the evidence for the efficacy and safety of antipsychotic medications in treating delirium. Study medications included haloperidol, chlorpromazine, olanzapine, risperidone, and quetiapine. Improvements in delirium severity were reported with all of these antipsychotic medications. No study included a placebo comparison to account for spontaneous improvements in delirium.  The improvements in delirium tended to occur soon after initiation of treatment, and most of the studies examined used relatively low doses of antipsychotic medication. Serious adverse events attributable to antipsychotic medication were uncommon in studies, although side effects were not evaluated systematically in most studies. To date, there are no published double-blind, randomized, placebo-controlled trials to establish the efficacy or safety of any antipsychotic medication in the management of delirium. There is limited evidence from uncontrolled studies that supports the use of low-dose, short-term treatment of delirium with some prescription drugs.

Psychiatry Investig. 2013. Two cases of hypersexuality probably associated with aripiprazole. Department of Psychiatry, Yeungnam University College of Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea. Sexual dysfunction is a common side effect in patients treated with antipsychotics but significant differences exist across different compounds. We report hypersexuality symptoms in two female patients with schizophrenia who were receiving treatment with aripiprazole. The patients experienced more frequent sexual desire and greater sexual preoccupation after taking aripiprazole. We discuss the potential neuro-chemical mechanisms for this and argue that aripiprazole’s unique pharmacological profile, partial agonism with high affinity at dopamine D2-receptor, may have contributed to the development of these symptoms.