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Monitoring of high-risk medications unchanged despite FDA warnings
Date:1/12/2010

baseline metabolic testing and ongoing monitoring for anyone beginning these medications.

In this study group that examined more than 100,000 patients in California, Missouri and Oregon it never happened.

There were no significant changes in the level of baseline testing for blood sugar and cholesterol. There was some movement toward one drug that posed less metabolic risk, the study found, but much of that could have been caused by the elimination in California, around the same time, of required prior authorization for that drug.

Second-generation antipsychotic drugs, such as olanzapine, aripiprazole and others, are very powerful medications and were originally developed for treatment of schizophrenia, Hartung said. They were largely prescribed at first only by psychiatrists, but their use has now expanded widely into treatment for problems such as bipolar disorder and less serious mental health problems such as depression, and they are often administered by general practitioners.

The study noted that individuals with serious mental illness often have a higher risk of diabetes and cardiovascular disease, and as such are already a vulnerable population. Since the new drugs can significantly increase those risks, monitoring blood sugar and cholesterol is very important, experts say.

"Part of the problem may be that simply sending doctors a letter about these issues, which come up every now and then with medications, is just not getting the job done," Hartung said. "With this group of medications, at least, it clearly wasn't effective, and it does raise questions about whether new approaches are needed. Part of the problem may also be people moving from one doctor to another, and inaccurate assumptions about testing being made."

"Also, changes in behavior are always slow," he said.

Anyone taking these medications, Hartung said, may wish to discuss with their physicians what type of metabolic screening t
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Contact: Daniel Hartung
hartungd@ohsu.edu
503-494-4720
Oregon State University
Source:Eurekalert

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