{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T16:06:29Z","timestamp":1794413189863,"version":"4.9.1"},"reference-count":41,"publisher":"Cambridge University Press (CUP)","issue":"16","license":[{"start":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T00:00:00Z","timestamp":1695772800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0033291723001502_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Individuals with schizophrenia exposed to second-generation antipsychotics (SGA) have an increased risk for diabetes, with aripiprazole purportedly a safer drug. Less is known about the drugs' mortality risk or whether serious mental illness (SMI) diagnosis or race\/ethnicity modify these effects.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291723001502_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>Authors created a retrospective cohort of non-elderly adults with SMI initiating monotherapy with an SGA (olanzapine, quetiapine, risperidone, and ziprasidone, aripiprazole) or haloperidol during 2008\u20132013. Three-year diabetes incidence or all-cause death risk differences were estimated between each drug and aripiprazole, the comparator, as well as effects within SMI diagnosis and race\/ethnicity. Sensitivity analyses evaluated potential confounding by indication.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291723001502_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>38 762 adults, 65% White and 55% with schizophrenia, initiated monotherapy, with haloperidol least (6%) and quetiapine most (26\u00b75%) frequent. Three-year mortality was 5% and diabetes incidence 9.3%. Compared with aripiprazole, haloperidol and olanzapine reduced diabetes risk by 1.9 (95% CI 1.2\u20132.6) percentage points, or a 18.6 percentage point reduction relative to aripiprazole users' unadjusted risk (10.2%), with risperidone having a smaller advantage. Relative to aripiprazole users' unadjusted risk (3.4%), all antipsychotics increased mortality risk by 1.1\u20132.2 percentage points, representing 32.4\u201364.7 percentage point increases. Findings within diagnosis and race\/ethnicity were generally consistent with overall findings. Only quetiapine's higher mortality risk held in sensitivity analyses.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291723001502_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>Haloperidol's, olanzapine's, and risperidone's lower diabetes risks relative to aripiprazole were not robust in sensitivity analyses but quetiapine's higher mortality risk proved robust. Findings expand the evidence on antipsychotics' risks, suggesting a need for caution in the use of quetiapine among individuals with SMI.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291723001502","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T08:24:18Z","timestamp":1695803058000},"page":"7677-7684","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":11,"title":["Antipsychotics and the risk of diabetes and death among adults with serious mental illnesses"],"prefix":"10.1017","volume":"53","author":[{"given":"Jason","family":"Poulos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon-Lise T.","family":"Normand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katya","family":"Zelevinsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John W.","family":"Newcomer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Agniel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haley K.","family":"Abing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8120-9313","authenticated-orcid":false,"given":"Marcela","family":"Horvitz-Lennon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2023,9,27]]},"reference":[{"key":"S0033291723001502_ref15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1915784"},{"key":"S0033291723001502_ref37","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2012.11.011"},{"key":"S0033291723001502_ref23","doi-asserted-by":"publisher","DOI":"10.1176\/appi.focus.15107"},{"key":"S0033291723001502_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31135-3"},{"key":"S0033291723001502_ref4","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-022-01817-0"},{"key":"S0033291723001502_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2021.11.023"},{"key":"S0033291723001502_ref16","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v69n0702"},{"key":"S0033291723001502_ref14","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2020.573479"},{"key":"S0033291723001502_ref36","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4419-9782-1"},{"key":"S0033291723001502_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2013.10.034"},{"key":"S0033291723001502_ref24","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kww165"},{"key":"S0033291723001502_ref21","unstructured":"Poulos, J. , Horvitz-Lennon, M. , Zelevinsky, K. , Cristea-Platon, T. , Huijskens, T. , Tyagi, P. , \u2026 Normand, S.-L. 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