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An Epidemiological Study of Psychotropic Medication and Obesity-Related Chronic Illnesses in Older Psychiatric Patients
Canadian Journal of Psychiatry, 05/05/09

Kisely S et al. - This study suggests that the association of psychotropics and 2 obesity-related conditions, hypertension and diabetes, applies to older psychiatric patients as well as younger populations. Within drug classes, there are drugs that have a greater association than others, and this may be a factor when choosing aspecific agent.

Methods

A population-based case–control study of all psychiatric patients aged 67 years or older in contactwith either specialist services or primary care using administrative data from Nova Scotia.

Results

We identified incident cases of diabetes (n = 608) and of hypertension (n = 1056), as well as anequal number of control subjects for each condition.
Amitryptiline, selective serotonin reuptake inhibitors(SSRIs), and olanzapine were associated with an increased risk of presenting with hypertension 6 monthsafter initial prescription.
By contrast, conventional antipsychotics were associated with a reduced incidenceof hypertension.
Olanzapine was also significantly associated with diabetes after 6 months (ORadj = 2.58,95% CI 1.12 to 5.92).
The findings for SSRIs and olanzapine remained significant after adjusting forpotential confounders such as sociodemographic characteristics, schizophrenia, beta blockers, thiazidediuretics, and corticosteroids.

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