Diabetes mellitus risk for 102 drugs and drug combinations used in patients with bipolar disorder.
Psychoneuroendocrinology
; 112: 104511, 2020 02.
Article
em En
| MEDLINE
| ID: mdl-31744781
ABSTRACT
OBJECTIVE:
To compare the largest set of bipolar disorder pharmacotherapies to date (102 drugs and drug combinations) for risk of diabetes mellitus (DM).METHODS:
The IBM MarketScan® database was used to retrospectively analyze data on 565,253 adults with bipolar disorder without prior glucose metabolism-related diagnoses. The pharmacotherapies compared were lithium, mood-stabilizing anticonvulsants, antipsychotics, and antidepressants (monotherapy and multi-class polypharmacy). Cox regression modeling included fixed pre-treatment covariates and time-varying drug exposure covariates to estimate the hazard ratio (HR) of each treatment versus "No drug".RESULTS:
The annual incidence of new-onset diabetes during the exposure period was 3.09 % (22,951 patients). The HR of drug-dependent DM ranged from 0.79 to 2.37. One-third of the studied pharmacotherapies, including most of the antipsychotic-containing regimens, had a significantly higher risk of DM compared to "No drug". A significantly lower DM risk was associated with lithium, lamotrigine, oxcarbazepine and bupropion monotherapies, selective serotonin reuptake inhibitors (SSRI) mono-class therapy and several drug combinations containing bupropion and an SSRI. As additional drugs were combined in more complex polypharmacy, higher HRs were consistently observed.CONCLUSIONS:
There is an increased risk of diabetes mellitus associated with antipsychotic and psychotropic polypharmacy use in bipolar disorder. The evidence of a lower-than-baseline risk of DM with lamotrigine, oxcarbazepine, lithium, and bupropion monotherapy should be further investigated.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Antipsicóticos
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Transtorno Bipolar
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Compostos de Lítio
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Antimaníacos
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Diabetes Mellitus
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Quimioterapia Combinada
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Anticonvulsivantes
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Antidepressivos
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article