Zyprexa, Metabolic Disfunction & Diabetes/ How Zyprexa can Kill You Part 2

Zyprexa associated with the highest incidence of metabolic disfunction.

Zyprexa and diabetes: Its not just that you're fat!  

From the following article: https://www.pharmacytimes.com/publications/issue/2012/march2012/olanzapine-and-clozapine-atypical-antipsychotic-induced-type-2-diabetes-

"Olanzapine and clozapine have the highest affinity for H1 receptors and are associated with the greatest weight gain; ziprasidone and aripiprazole have the lowest affinity for H1 receptors."

And....

"Some patients develop diabetes without concomitant changes in BMI, however; therefore, there must be other possibilities aside from the weight gain. One possible mechanism involves alterations in pancreatic beta-cells, specifically antagonism of pancreatic adrenergic alpha 2 receptors, 5-HT1 alpha receptors, and/ or muscarinic M3 receptors. When these receptors are blocked, the beta-cells in the pancreas lose the ability to respond to changes in blood glucose levels. Another possibility involves alterations in glucose transporters on hepatic and skeletal muscle tissue. When these transporters are inhibited, glucose cannot get to target tissue and high levels of glucose remain in the blood.9 This is not a complete list of possible mechanisms; there is much more work to be done to fully explain why atypical antipsychotic medications induce type 2 diabetes."

Also,

"If there is a rise in triglycerides or weight gain, a switch to another agent, such as ziprasidone or aripiprazole, should be considered, and the patient should continue to be monitored. If a patient has dyslipidemia, pre-diabetes, or diabetes prior to initiating antipsychotic medication, it is recommended to avoid high-risk medications such as olanzapine and clozapine and to watch for signs and symptoms of diabetic ketoacidosis/hyperglycemic hyperosmolar syndrome.11"


"Of the atypical antipsychotics, clozapine and olanzapine are associated with the highest incidence of metabolic disfunction, whereas ziprasidone and aripiprazole are considered to be the least risky."


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