Fwd: Diabetes link to child mind drugs

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http://news.bbc.co.uk/2/hi/health/3757124.stm

 

 

Last Updated: Saturday, 23 October, 2004, 00:14 GMT 01:14 UK

 

 

Diabetes link to child mind drugs

 

Treating children with anti-psychotic drugs may increase the risk of

a condition which leads to diabetes and heart disease, research

suggests.

 

A team from Johns Hopkins University looked at 'atypical'

antipsychotics, used to treat behavioural problems such as manic

depression and schizophrenia.

 

They found their use may trigger insulin resistance.

 

The research was presented to a meeting of the American Academy of

Child and Adolescent Psychiatry.

 

Insulin resistance

Insulin resistance occurs when muscle, fat, and liver cells do not

properly use insulin

Insulin is a hormone produced by the pancreas that helps cells

absorb glucose and provides a source of energy to the body

The pancreas tries to keep up with the demand for insulin by producing more

Eventually, the pancreas cannot keep up with the body's need for

insulin, and excess glucose builds up in the bloodstream

The condition is associated with an increased risk of developing

Type 2 diabetes, heart disease, and stroke

The Johns Hopkins team evaluated 11 children who gained significant

amounts of weight while taking the atypical drugs olanzapine,

quetiapine, and risperidone.

 

Considerable weight gain is a common side effect of atypical

antipsychotic medications - and is also one of the many factors that

can contribute to insulin resistance.

 

All six children on moderate or high doses of one of these drugs,

and three of five children on low doses, had evidence of insulin

resistance.

 

This is a condition in which the body cannot properly use the

insulin it produces.

 

Lead researcher Dr Mark Riddle said: " The insulin resistance seen in

these children was greater than what would be expected from weight

gain alone, suggesting there is a factor distinct from excess weight

that directly induces insulin resistance. "

 

Balance to be struck

 

In general, the new-generation antipsychotics create fewer side

effects than older drugs.

 

The drugs, which balance certain chemicals in the brain and

stabilise mood, have successfully treated countless numbers of

children since being introduced in the 1990s.

 

Dr Riddle said: " Treatments are always a matter of risk and benefit

balance. Clearly these drugs are an important treatment option.

 

" But diabetes and heart disease are serious health issues, so it's

important to further investigate this apparent relationship between

atypical antipsychotics and insulin production and consumption.

 

" We may need to re-examine how we are prescribing these drugs to see

if dosage changes can be made to ensure children will continue to

receive the benefits of these medications while not putting them at

risk for developing other health problems in the future. "

 

Cliff Prior, chief executive of the mental health charity Rethink,

said: " There is no doubt that the early diagnosis and treatment of

schizophrenia improves outcomes, but treatment should never rely

totally on medicines.

 

" Many of the medicines used for schizophrenia have not been tested

with children, and the greatest care is needed in this area. "

 

If children are receiving these drugs one would sincerely hope it

was under the close supervision of a child or adolescent

psychiatrist.

 

Dr Tim Fox

Mr Prior said antipsychotic medications were powerful medicines that

had a major effect on brain chemistry.

 

" They are often used for long-term treatments and their side effects

- which vary greatly between individuals - need to be carefully

monitored.

 

" People using them need regular reviews and the opportunity to

exercise an informed choice over which they use. "

 

Dr Tim Fox, an associate editor of the journal Drugs and

Therapeutics Bulletin, said the drugs were not recommended for use in

children and adolescents in the UK, but were almost certainly given

to young people who developed mental health problems.

 

" There is some evidence that children may be more susceptible to a

number of side effects of antipsychotic treatments, " he told BBC News

Online.

 

" If children are receiving these drugs one would sincerely hope it

was under the close supervision of a child or adolescent

psychiatrist. "

 

Dinah Morley, of the charity Young Minds, Young said young people

with severe mental illnesses were an extremely vulnerable group.

 

" What is needed is rigorous research into all treatments used on

children, including drugs, to develop the evidence base and to

safeguard children and young people from harmful side effects. "

 

Amanda Vezey, of the charity Diabetes UK, said: " This is an

interesting study and we would be interested to see the larger

studies into the causes of insulin resistance in children who take

antipsychotic drugs. "

 

 

 

 

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