Newcomer Publishes Paper Examining Medication Effects on Diabetic Patients with Mental Illness
Patients with major depressive disorder (MDD) have an increased risk of developing metabolic syndrome (a combination of metabolic factors that increases the risk of developing type 2 diabetes mellitus and cardiovascular disease) and type 2 diabetes mellitus. In addition to lifestyle and dietary factors, some medications can increase risk for type 2 diabetes, potentially due to drug-related weight gain or direct effects on glucose metabolism via altered insulin resistance or secretion. It is important that prescribers select an agent that has minimal effect on metabolic parameters and weight—particularly among patients who may be vulnerable to diabetes, such as those with prediabetes. The aim of this post hoc analysis was to determine the effect of brexpiprazole as an adjunctive treatment to antidepressants on metabolic parameters and body weight in adults with major depressive disorder and prediabetes compared with those who do not have prediabetes/diabetes (termed non-diabetes), based on pooled data from 3 short-term studies and 1 long-term extension study.
Most patients receiving adjunctive brexpiprazole maintained baseline diabetes status in the short term (568/751; 75.6%) and long term (1,919/2,746; 69.9%). The incidence of categorical shifts in fasting metabolic parameters generally did not differ between treatment groups or between prediabetes and non-diabetes subgroups. Mean changes from baseline in metabolic parameters were small in the short term (all < 5 mg/dL) and long term (all < 6 mg/dL, except < 20 mg/dL for triglycerides). Moderate weight gain was observed in the short term (1.5 kg) and long term (3.4–4.1 kg).
In conclusion, adjunctive brexpiprazole was associated with small changes in metabolic parameters and moderate weight gain during short- and long-term treatment, likely to be of limited clinical significance. Results were comparable between subgroups with and without prediabetes, suggesting that adjunctive brexpiprazole had a limited impact on the metabolic profile of patients with major depressive disorder, regardless of diabetes status (prediabetes or non-diabetes).
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