Antipsychotics in Teens Linked to Rising Diabetes Risk - Aman Shanti News

A study from the Netherlands suggests that starting antipsychotic medications in young people may increase their risk of developing Type 2 diabetes.

These drugs are prescribed off-label, meaning outside their officially approved use, to children and teenagers for conditions such as irritability related to autism spectrum disorder, attention-deficit/hyperactivity disorder, anxiety, and sleep problems.

Research shows that roughly 60 percent to more than 80 percent of antipsychotic prescriptions given to minors are for off-label use.

The findings suggest that even short-term use can significantly increase the likelihood of developing Type 2 diabetes, which affects more than 34 million adults and is rising among youth in the United States.

Risk Increased With Continued Use

The study, published in July in JAMA Network Open, tracked medical records of roughly 90,000 young people over several years and compared diabetes diagnoses before and after they started antipsychotic treatment. The researchers found that even short-term use was linked to a meaningfully higher chance of developing Type 2 diabetes.

The risk of diabetes increased with continued use of these medications, with the annual difference in new diabetes cases rising from about 2.5 per 10,000 users in the first year to more than nine per 10,000 after five years—roughly a fourfold increase.

Girls and teenagers ages 13 to 19 experienced a greater long-term increase in risk compared with boys and younger children, though the reasons for that gender and age gap weren’t addressed in the study.

Even patients who took the medication only briefly, during their first year, still showed elevated diabetes risk later on, suggesting the effect isn’t limited to long-term users. This tracks with previous research indicating that young people treated with antipsychotics are two to three times more likely to develop Type 2 diabetes than their peers who were not.

Previous research shows the risk is not uniform across all medications, with specific antipsychotics carrying varying levels of metabolic risk:

Olanzapine (Zyprexa) consistently ranks as the highest-risk medication for minors. It causes the most significant increases in body fat, rapid weight gain, and drastic drops in insulin sensitivity.

Clozapine (Clozaril) is less frequently prescribed to minors as a first-line treatment, but it carries an equally high risk of profound metabolic changes, rapid weight gain, and new-onset diabetes.

Why Antipsychotics Increase Diabetes Risk

The primary reasons antipsychotics increase the risk of Type 2 diabetes include an often rapid increase in body mass triggered by increased activity in brain receptors and surrounding tissues.

Dr. Vinay Saranga, a psychiatrist and founder of The North Carolina Institute of Advanced NeuroHealth who wasn’t involved in the study, described several ways antipsychotics can disrupt metabolism—some tied to weight gain, others independent of it.

Some antipsychotics interfere with receptors in the brain’s hypothalamus, the region that regulates hunger and energy use. Blocking these receptors can trigger intense cravings, dull the body’s natural sense of fullness, and slow metabolism, a combination that drives rapid weight gain, itself a major diabetes risk factor.

Separately, the drugs can raise blood sugar even in patients who haven’t gained weight. They block a receptor called M3 on the insulin-producing cells of the pancreas, limiting the body’s ability to release insulin after eating. They can also disrupt normal liver signaling, causing the liver to keep releasing stored sugar into the bloodstream even when blood sugar is already high, and interfere with how muscle tissue absorbs sugar from the blood.

Beyond diabetes risk, Saranga noted that some antipsychotics can raise cholesterol and blood pressure, cause fatigue, dry mouth, or constipation, and in some cases lead to tremors and muscle stiffness. Less frequently, hormonal imbalances can also occur.

“When it comes to children and adolescents specifically, these side effects are especially concerning because we’re potentially exposing them to health risks that can follow them for years,” Saranga told The Epoch Times. “It’s always a question of if the benefits outweigh the risks.”

Weighing the Risks

Saranga was clear that antipsychotics still have an important place in treating young people when the clinical need is real. “They can be extremely valuable medications for conditions like psychotic disorders, severe bipolar disorder, and certain serious behavioral symptoms.”

The calculation changes, he said, when the drugs are used for milder symptoms with safer alternatives available. “There’s definitely a long list of first-line treatments you would have to exhaust first before I would even consider one of these medications for anxiety or insomnia.”

For every patient, he said, a risk-benefit equation must be considered. If a young person has a severe condition and an antipsychotic is dramatically improving their functioning or safety, the benefits may “absolutely” outweigh the risks.

Alternatives to Off-Label Antipsychotic Use

Before reaching for medication, Saranga recommends figuring out what is causing the symptoms.

“Does this child have a true anxiety disorder, or could it be something at home or school that is causing them to be anxious? Same goes for irritability and insomnia,” he said.

These can be the direct result of something not related to the child’s health, like simply not getting enough sleep, Saranga added, or they can be symptoms of a number of mental and physical health issues.

“You have to do a thorough assessment to see what you are actually dealing with and identify the root cause first,” he said.

Once other causes are ruled out, Saranga points to established first-line treatments. The first-line treatment for insomnia includes good sleep hygiene and behavioral therapy. For anxiety, he recommends trying cognitive behavioral therapy (CBT) before considering medication for mild symptoms.

However, for moderate to severe symptoms, Saranga said a combination of CBT and medication is often needed, primarily because medication can enhance therapy effectiveness.

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