Antipsychotic Drugs and Dysregulated Glucose Homeostasis

作者：Emily C. C. Smith, Sri Mahavir Agarwal, Kristoffer Panganiban, Kateryna Maksyutynska, Jonathan Monteiro, Jiwon Lee, Femin Prasad, Andrew Ji, Divia Shah, Samantha Cavalier, Reva U. Prabhune, Emril Radoncic, Zilu Yang, Kaitlin Fuller, Michael J. McCarthy, Tyler R. Prestwood, Jacob S. Ballon, Christoph U. Correll, Margaret Hahn, Zachary Freyberg · 发表于：JAMA Psychiatry · 年份：2025 · DOI：10.1001/jamapsychiatry.2025.2240 · 被引用次数：12 · 研究领域：Schizophrenia research and treatment、Diabetes Treatment and Management、Bipolar Disorder and Treatment

Importance: Antipsychotic drug (AP)-induced glucose homeostasis changes are often attributed to AP-induced weight gain. Nevertheless, dysregulated glucose control can occur independently of weight gain. Objective: To examine the association between AP use and glucose homeostasis while considering weight gain propensity, medication type, and treatment duration. Data Sources: MEDLINE, Embase, PsychINFO, CINAHL, the Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science were searched from inception through February 3, 2025. Study Selection: Blinded randomized clinical trials (RCTs) comparing changes in glucose homeostasis-related parameters between patients with severe mental illness or healthy volunteers assigned to AP or control (placebo or no intervention) groups were included. Studies were limited to English-language human studies without restrictions on study length, AP type, or previous AP exposure. Of 22 773 unique citations, 163 RCTs met inclusion criteria, with 127 studies included in the meta-analysis. Data Extraction and Synthesis: Each article was screened independently by 2 authors using predefined inclusion and exclusion criteria. Data extraction and risk of bias assessment were completed using a standardized spreadsheet. Data were analyzed via random-effects meta-analysis, with subgroup analyses for diagnosis, study length, AP type, age, concomitant medication use, and previous AP exposure. Metaregressions identified covariate effects. Data a...