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Perez-Iglesias et al. (2007) examined the mainmetabolic side effects induced by antipsychotictreatment in a cohort of first-episode, drug-naivesubjects using a randomized, open-label, and pro-spective clinical trial. Clients were assigned tohaloperidol (typical), olanzapine (atypical), andrisperidone (atypical) treatment groups over a 12-week period. Significant weight gain was observedwith all three antipsychotics, and metabolic para-meters showed a worsening lipid profile with thethreetreatments.Theirfindingsunderscorethatdrug-naiveclientsexperienceanextraordinaryweightgainwith typical and atypical antipsychotics. Followingthe 12-week study period, there was no significantchange in parameters involving glucose metabolismfor any group. However, the findings reveal thatweight gain and metabolic disturbances induced byantipsychotic treatment may increase the risk ofdeveloping weight-related physical illnesses, such ascardiovascular disease and diabetes.In an earlier study, Wang et al. (2002) examinedwhether the atypical antipsychotic clozapineincreased the risk of developing diabetes relativeto other antipsychotics and to dosage or duration ofclozapine use. The researchers performed a case–control study involving a sample of 7,227 indivi-duals newly diagnosed with and treated for diabetesand 6,780 controls (non-diabetes), all of whomwere diagnosed with and treated for psychiatricdisorders. The results revealed that non-clozapineantipsychotic use was associated with an increasedrisk of developing diabetes and that clozapine usewas not significantly associated with developingdiabetes (Wang et al., 2002).Similarly, an analysis of prospective data fromrandomized clinical trials undertaken by Bushe andLeonard (2007) revealed no consistent significantdifference in the incidence of treatment-emergentglucose abnormalities in clients treated withatypical antipsychotics (Bushe & Leonard, 2007).The data reviewed by Bushe and Leonard werehowever not sufficient to reach conclusions relatedto glucose abnormalities regarding clients receivinglonger-term treatment with atypical antipsychotics.This suggests that more research is needed toinvestigate whether there is a direct causal effectbetween atypical antipsychotics and the develop-ment of diabetes. However, the studies highlightsome increases in risk related to drug-inducedchanges in metabolic parameters leading to changesin weight and lipid levels.
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