Hyperglycemic adverse events following antipsychotic drug administration in spontaneous adverse event reports

Yamato Kato; Ryogo Umetsu; Junko Abe; Natsumi Ueda; Yoko Nakayama; Yasutomi Kinosada; Mitsuhiro Nakamura

doi:10.1186/s40780-015-0015-6

Hyperglycemic adverse events following antipsychotic drug administration in spontaneous adverse event reports

J Pharm Health Care Sci. 2015 Apr 16:1:15. doi: 10.1186/s40780-015-0015-6. eCollection 2015.

Authors

Yamato Kato¹, Ryogo Umetsu¹, Junko Abe², Natsumi Ueda¹, Yoko Nakayama¹, Yasutomi Kinosada³, Mitsuhiro Nakamura¹

Affiliations

¹ Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196 Japan.
² Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196 Japan ; Medical Database Co., LTD, 3-11-10, Higashi, Sibuya Ward, Tokyo, 150-0011 Japan.
³ Department of Biomedical Informatics, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1196 Japan.

Abstract

Background: Antipsychotics are potent dopamine antagonists used to treat schizophrenia and bipolar disorder. The aim of this study was to evaluate the relationship between antipsychotic drugs and adverse hyperglycemic events using the FDA Adverse Event Reporting System (FAERS) database. In particular, we focused on adverse hyperglycemic events associated with atypical antipsychotic use, which are major concerns.

Findings: We analyzed reports of adverse hyperglycemic events associated with 26 antipsychotic drugs in the FAERS database from January 2004 to March 2013. The Standardized Medical Dictionary for Regulatory Activities Queries (SMQ) preferred terms (PTs) was used to identify adverse hyperglycemic events. The number of adverse hyperglycemic reports for the top eight antipsychotic drugs, quetiapine, olanzapine, risperidone, aripiprazole, haloperidol, clozapine, prochlorperazine, and chlorpromazine was 12,471 (28.9%), 8,423 (37.9%), 5,968 (27.0%), 4,045 (23.7%), 3,445 (31.5%), 2,614 (14.3%), 1,800 (19.8%), and 1,003 (35.7%), respectively. The reporting ratio increased with co-administration of multiple antipsychotic drugs. For example, adverse hyperglycemic events represented 21.6% of reports for quetiapine monotherapy, 39.9% for two-drug polypharmacy, and 66.3% for three-drug polypharmacy.

Conclusion: Antipsychotic drug polypharmacy may influence signal strength, and may be associated with hyperglycemia. After considering the causality restraints of the current analysis, further robust epidemiological studies are recommended.

Keywords: Adverse event reporting system; Antipsychotic drugs; Antipsychotic monotherapy; Antipsychotic polypharmacy; Hyperglycemic adverse events.