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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 3 to 27 of 27. Go back in thread:
Posted by Lou Pilder on November 6, 2010, at 16:31:26
In reply to antipsychotics and diabetes, posted by maya3 on November 6, 2010, at 11:39:30
> Hi,
> Does anyone know the mechanism through which APs can bring about diabetes and related disorders?
> Thanks.maya,
You wrote,[...does anyone know the mechanism...?]
I do know, but I am unsure as to why you have posted that request. If you could post answers to the following, then I could have the opportunity to respond accordingly.
You asked because:
1A. you want to know if members here know
2A. you want to find out the mechanism because you don't know
1B. if you do not know, and you find out, then maybe you could evade those diseases by taking those chemicals and do something to offset the potential for the mechanism to cause those diseases
2B. something else
Is it 2B or not 2B?
Lou
Posted by ed_uk2010 on November 6, 2010, at 16:39:10
In reply to Lou's reply-nrvehyjentz » maya3, posted by Lou Pilder on November 6, 2010, at 16:31:26
>I do know, but I am unsure as to why you have posted that request.
I suspect that she posted because she wants an answer.
Posted by ed_uk2010 on November 6, 2010, at 16:54:29
In reply to antipsychotics and diabetes, posted by maya3 on November 6, 2010, at 11:39:30
> Hi,
> Does anyone know the mechanism through which APs can bring about diabetes and related disorders?Substantial weight gain can be a causative factor in many cases, but it is not the only mechanism. Antipsychotics can induce a variety of metabolic disturbances. Amongst other things, they often reduce 'glucose tolerance', perhaps by creating a degree of insulin resistance. I think it's fair to say that antipsychotics are drugs which should only be prescribed when they are clearly necessary. No one should be taking APs for non-serious psychiatric problems.
In elderly patients with dementia, the risk of death is elevated by the use of antipsychotics. Over the course of a typical 10-week controlled trial in dementia patients, the rate of death in drug-treated patients was about 4.5%, compared to a rate of about 2.6% in the placebo group. Most deaths were cardiovascular or due to pneumonia (possibly aspiration?).
To what extent antipsychotics affect mortality in young patients with psychiatric illness is not known. Clearly, cardiovascular risk factors need to be monitored and controlled eg. diabetes, BP, weight, smoking, lipids etc. Many patients require additional medication eg. statins, antihypertensives, Xenical, Glucophage.
Posted by emmanuel98 on November 6, 2010, at 19:42:13
In reply to Antipsychotics and mortality, posted by ed_uk2010 on November 6, 2010, at 16:54:29
I asked my p-doc why AAPs can cause diabetes and weight gain and he said nobody really understands it.
Posted by Maxime on November 6, 2010, at 20:40:17
In reply to Antipsychotics and mortality, posted by ed_uk2010 on November 6, 2010, at 16:54:29
My pet peeve is when they are prescribed for sleep.
Posted by maya3 on November 7, 2010, at 6:35:15
In reply to Re: antipsychotics and diabetes » maya3, posted by Phillipa on November 6, 2010, at 12:41:34
> What an excellent question as I just thought it was the weight gain but if that was so anyone overweight would have diabetes. I wonder what google says? Must be a lot of infor there. Something to look up myself. Phillipa
Thanks, Phillipa, I will google it...
Posted by maya3 on November 7, 2010, at 6:37:20
In reply to Lou's reply-nrvehyjentz » maya3, posted by Lou Pilder on November 6, 2010, at 16:31:26
> > Hi,
> > Does anyone know the mechanism through which APs can bring about diabetes and related disorders?
> > Thanks.
>
> maya,
> You wrote,[...does anyone know the mechanism...?]
> I do know, but I am unsure as to why you have posted that request. If you could post answers to the following, then I could have the opportunity to respond accordingly.
> You asked because:
> 1A. you want to know if members here know
> 2A. you want to find out the mechanism because you don't know
> 1B. if you do not know, and you find out, then maybe you could evade those diseases by taking those chemicals and do something to offset the potential for the mechanism to cause those diseases
> 2B. something else
> Is it 2B or not 2B?
> LouActually, it is all but 2B :)
Posted by maya3 on November 7, 2010, at 6:39:36
In reply to Antipsychotics and mortality, posted by ed_uk2010 on November 6, 2010, at 16:54:29
> > Hi,
> > Does anyone know the mechanism through which APs can bring about diabetes and related disorders?
>
> Substantial weight gain can be a causative factor in many cases, but it is not the only mechanism. Antipsychotics can induce a variety of metabolic disturbances. Amongst other things, they often reduce 'glucose tolerance', perhaps by creating a degree of insulin resistance. I think it's fair to say that antipsychotics are drugs which should only be prescribed when they are clearly necessary. No one should be taking APs for non-serious psychiatric problems.
>
> In elderly patients with dementia, the risk of death is elevated by the use of antipsychotics. Over the course of a typical 10-week controlled trial in dementia patients, the rate of death in drug-treated patients was about 4.5%, compared to a rate of about 2.6% in the placebo group. Most deaths were cardiovascular or due to pneumonia (possibly aspiration?).
>
> To what extent antipsychotics affect mortality in young patients with psychiatric illness is not known. Clearly, cardiovascular risk factors need to be monitored and controlled eg. diabetes, BP, weight, smoking, lipids etc. Many patients require additional medication eg. statins, antihypertensives, Xenical, Glucophage.Thank you for this helpful information, Ed.
Posted by maya3 on November 7, 2010, at 6:42:06
In reply to Re: Antipsychotics and mortality, posted by emmanuel98 on November 6, 2010, at 19:42:13
> I asked my p-doc why AAPs can cause diabetes and weight gain and he said nobody really understands it.
Yes, that's one of the problems with meds which have been on the market for a relatively short while...it is rather frightening.
Posted by maya3 on November 7, 2010, at 6:49:12
In reply to Re: Antipsychotics and mortality » ed_uk2010, posted by Maxime on November 6, 2010, at 20:40:17
> My pet peeve is when they are prescribed for sleep.
Yes, it is hard to understand why pdocs prescribe APs for sleep for patients who can respond to other meds or treatments.
Posted by ed_uk2010 on November 7, 2010, at 9:31:32
In reply to Re: Antipsychotics and mortality » emmanuel98, posted by maya3 on November 7, 2010, at 6:42:06
> > I asked my p-doc why AAPs can cause diabetes and weight gain and he said nobody really understands it.
>
>Yes, that's one of the problems with meds which have been on the market for a relatively short while...it is rather frightening.Traditional antipsychotics can also cause weight gain and diabetes. As is the case with atypicals, the risk varies between drugs. Haloperidol (Haldol) usually only causes modest weight gain. Chlorpromazine often causes quite a lot of weight gain.
Posted by Conundrum on November 7, 2010, at 11:18:15
In reply to antipsychotics and diabetes, posted by maya3 on November 6, 2010, at 11:39:30
> Hi,
> Does anyone know the mechanism through which APs can bring about diabetes and related disorders?
> Thanks.A lighthearted look at the issue.
Posted by maya3 on November 7, 2010, at 15:51:47
In reply to Re: Antipsychotics and mortality, posted by ed_uk2010 on November 7, 2010, at 9:31:32
> > > I asked my p-doc why AAPs can cause diabetes and weight gain and he said nobody really understands it.
> >
> >Yes, that's one of the problems with meds which have been on the market for a relatively short while...it is rather frightening.
>
> Traditional antipsychotics can also cause weight gain and diabetes. As is the case with atypicals, the risk varies between drugs. Haloperidol (Haldol) usually only causes modest weight gain. Chlorpromazine often causes quite a lot of weight gain.
>Do you think the low potency drugs are more problematic in this area?
Posted by maya3 on November 7, 2010, at 15:52:47
In reply to Why Atypical Antipsychotics Make You Fat, posted by Conundrum on November 7, 2010, at 11:18:15
> > Hi,
> > Does anyone know the mechanism through which APs can bring about diabetes and related disorders?
> > Thanks.
>
> A lighthearted look at the issue.
>
> http://thelastpsychiatrist.com/2010/10/zyprexa_and_fat.htmlThanks...interesting!
Posted by Lou Pilder on November 7, 2010, at 17:14:28
In reply to Re: Lou's reply-nrvehyjentz » Lou Pilder, posted by maya3 on November 7, 2010, at 6:37:20
> > > Hi,
> > > Does anyone know the mechanism through which APs can bring about diabetes and related disorders?
> > > Thanks.
> >
> > maya,
> > You wrote,[...does anyone know the mechanism...?]
> > I do know, but I am unsure as to why you have posted that request. If you could post answers to the following, then I could have the opportunity to respond accordingly.
> > You asked because:
> > 1A. you want to know if members here know
> > 2A. you want to find out the mechanism because you don't know
> > 1B. if you do not know, and you find out, then maybe you could evade those diseases by taking those chemicals and do something to offset the potential for the mechanism to cause those diseases
> > 2B. something else
> > Is it 2B or not 2B?
> > Lou
>
> Actually, it is all but 2B :)
>maya3,
You wrote,[...all but 2B..]
Now looking then at 1B, I am unsure if you are already taking the drug. If you could post answers to the following, then I could have the opportunity to respond accordingly.
1A. I am trying to decide to take an AP drug or not
2A. I am trying to decide to take any psychotropic drug.
1B. I am taking an AP
2B. if I find the {mechanism}, then that will open the door to___your answer here__________
1C. something else
Lou
Posted by Maxime on November 7, 2010, at 21:40:08
In reply to Lou's reply-wunbee » maya3, posted by Lou Pilder on November 7, 2010, at 17:14:28
Hi Lou, maybe Maya would be more open to responding to your posts if you wrote in the same narrative style as you do in your shop. :)
Posted by maya3 on November 8, 2010, at 8:32:41
In reply to Lou's reply-wunbee » maya3, posted by Lou Pilder on November 7, 2010, at 17:14:28
> 1A. I am trying to decide to take an AP drug or not
> 2A. I am trying to decide to take any psychotropic drug.
> 1B. I am taking an AP
> 2B. if I find the {mechanism}, then that will open the door to___your answer here__________
> 1C. something else
> Lou
>1A is correct.
2B, in this case, is also an appropriate answer :)
If, for instance, it turns out that the main cause of metabolic disorders is the weight gain, then at least that is something I can attempt to control...
Posted by Lou Pilder on November 8, 2010, at 9:33:35
In reply to Re: Lou's reply-wunbee » Lou Pilder, posted by maya3 on November 8, 2010, at 8:32:41
> > 1A. I am trying to decide to take an AP drug or not
> > 2A. I am trying to decide to take any psychotropic drug.
> > 1B. I am taking an AP
> > 2B. if I find the {mechanism}, then that will open the door to___your answer here__________
> > 1C. something else
> > Lou
> >
>
> 1A is correct.
> 2B, in this case, is also an appropriate answer :)
> If, for instance, it turns out that the main cause of metabolic disorders is the weight gain, then at least that is something I can attempt to control...
>
maya3,
As I see it, you specified that:
1A. You are trying to decide as to take an AP or not
2A. That if you find out the cause of the diseases from taking an AP, you could offset such if it is in your control.
Now if you are trying to decide, and your consideration is if you could offset diabetes and such from taking the drug, be advised that my research shows that the diabetes may not be from the gain in weight, but from another cause from the drug that one can not offset. Also, other potential life-ruining conditions that one could get from taking the drugs may not be in control by the one taking the drug such as akethesia, tardive dyskinesia, death from cardiac arrest, blood disease, and death by other causes. There are generally accepted now to be 40,000 people each year that die as from one reason or another from psychotropic drugs. This may be just in the U.S. This figure could be 400,000 per year if one considers that not all deaths from psychotropic drugs are reported as being from the drug and that some give a 100 to 1 ratio. This means that going forward the trend could mean that millions of people could die from taking psychotropic drugs unless the trend changes. So if you are trying to decide to take these drugs or not, if you post answers to the following, then I could have the opportunity to respond accordingly.I am trying to decide to take or not the drug because:
A.Someone told me that you could feel better if you did and I will take the drug on that basis
1B. A doctor wants you to take an AP
2B. The doctor has not told me that the drug could or could not cause an addiction to it.
3B. The doctor has not told me that when I stop the drug I could go through a horrific withdrawal
4B. The doctor has not told me that the drug could induce a mind-altered state that could compel me to want to kill myself and/or others.
5B. The doctor has not told me that the drug company that makes the drug will not pay for any pain or suffering that I my have from taking the drug or provide to my survivors a death benifit if I was to die as a result of taking the drug.
6B. The doctor has not explained the {mechanism} that causes diabetes from taking the drug or the other life-threatening conditions that the drug could induce
7B. The doctor has not disclosed as to if he/she is receiving money from the drug manufacturer.
8B. other potential non-disclosures that could arise if you take the drug.
9B. The octor has not explained the placebo effect nor explained the history of nerve agents.
10B. something else
Lou
Posted by ed_uk2010 on November 8, 2010, at 13:48:12
In reply to Re: Antipsychotics and mortality » ed_uk2010, posted by maya3 on November 7, 2010, at 15:51:47
> > > > I asked my p-doc why AAPs can cause diabetes and weight gain and he said nobody really understands it.
> > >
> > >Yes, that's one of the problems with meds which have been on the market for a relatively short while...it is rather frightening.
> >
> > Traditional antipsychotics can also cause weight gain and diabetes. As is the case with atypicals, the risk varies between drugs. Haloperidol (Haldol) usually only causes modest weight gain. Chlorpromazine often causes quite a lot of weight gain.
> >
>
> Do you think the low potency drugs are more problematic in this area?
>You mean with respect to the typical neuroleptics?
Posted by maya3 on November 8, 2010, at 15:37:03
In reply to Lou's reply-ehyvhnyufrdhehth » maya3, posted by Lou Pilder on November 8, 2010, at 9:33:35
> I am trying to decide to take or not the drug because:
> A.Someone told me that you could feel better if you did and I will take the drug on that basis
> 1B. A doctor wants you to take an AP
> 2B. The doctor has not told me that the drug could or could not cause an addiction to it.
> 3B. The doctor has not told me that when I stop the drug I could go through a horrific withdrawal
> 4B. The doctor has not told me that the drug could induce a mind-altered state that could compel me to want to kill myself and/or others.
> 5B. The doctor has not told me that the drug company that makes the drug will not pay for any pain or suffering that I my have from taking the drug or provide to my survivors a death benifit if I was to die as a result of taking the drug.
> 6B. The doctor has not explained the {mechanism} that causes diabetes from taking the drug or the other life-threatening conditions that the drug could induce
> 7B. The doctor has not disclosed as to if he/she is receiving money from the drug manufacturer.
> 8B. other potential non-disclosures that could arise if you take the drug.
> 9B. The octor has not explained the placebo effect nor explained the history of nerve agents.
> 10B. something else
> LouAll except A.
Actually, many doctors want me to take an AP. I suffer from schizophrenia.
Posted by maya3 on November 8, 2010, at 15:41:21
In reply to Re: Antipsychotics and mortality » maya3, posted by ed_uk2010 on November 8, 2010, at 13:48:12
> >
> > Do you think the low potency drugs are more problematic in this area?
> >
>
> You mean with respect to the typical neuroleptics?
Yes.
I understand that the question is irrelevant in respect to atypicals?
Posted by ed_uk2010 on November 8, 2010, at 15:59:12
In reply to Re: Antipsychotics and mortality » ed_uk2010, posted by maya3 on November 8, 2010, at 15:41:21
>
> > >
> > > Do you think the low potency drugs are more problematic in this area?
> > >
> >
> > You mean with respect to the typical neuroleptics?
>
>
> Yes.
> I understand that the question is irrelevant in respect to atypicals?
>Yes, the low potency typicals cause more weight gain than the high potency typicals.
Among the atypicals, each drug has its own unique adverse effect profile. Clozaril and Zyprexa cause the most weight gain, but they are also among the most effective, especially Clozaril.
Posted by maya3 on November 8, 2010, at 16:07:07
In reply to Re: Antipsychotics and mortality, posted by ed_uk2010 on November 8, 2010, at 15:59:12
> Yes, the low potency typicals cause more weight gain than the high potency typicals.
>
> Among the atypicals, each drug has its own unique adverse effect profile. Clozaril and Zyprexa cause the most weight gain, but they are also among the most effective, especially Clozaril.What is your opinion regarding abilify?
Posted by ed_uk2010 on November 9, 2010, at 13:39:51
In reply to Re: Antipsychotics and mortality » ed_uk2010, posted by maya3 on November 8, 2010, at 16:07:07
>What is your opinion regarding abilify?
It can cause weight gain, although it's not as bad as most of the other atypicals. Also, Geodon doesn't usually cause too much weight gain.
Posted by maya3 on November 9, 2010, at 14:04:05
In reply to Re: Antipsychotics and mortality, posted by ed_uk2010 on November 9, 2010, at 13:39:51
This is the end of the thread.
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