Thursday, January 7, 2010

Metabolic risks remain largely unmonitored in Medicaid patients taking antipsychotics

Despite government warnings and professional recommendations about diabetes risks associated with second-generation antipsychotic drugs, fewer than one-third of Medicaid patients who are treated with these medications undergo blood glucose or lipid tests, according to a new report.

Researchers studied laboratory claims data from the Medicaid populations of California, Missouri and Oregon between 2002 and 2005. They compared metabolic testing rates between a group of 109,451 patients receiving second-generation antipsychotics (aripiprazole, olanzapine, olanzapine/fluoxetine, quetiapine, risperidone or ziprasidone) and a control group of 203,527 patients who began taking albuterol but not an antipsychotic.

Initial testing rates for patients treated with second-generation antipsychotics were low — 27% underwent glucose testing and 10% underwent lipid testing.

In 2003, the FDA started requiring a warning on labels of second-generation antipsychotics, including olanzapine, fluoxetine and risperidone, describing an increased risk for hyperglycemia and diabetes. The warning stated that glucose levels should be monitored in patients with diabetes, at risk for the disease or with symptoms of hyperglycemia. At the same time, the American Diabetes Association and American Psychiatric Association published a consensus statement describing the metabolic risks associated with second-generation antipsychotics and specifying a monitoring protocol for all patients receiving these medications.


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