Trial reportDiabetes2013
Antipsychotic-induced insulin resistance and postprandial hormonal dysregulation independent of weight gain or psychiatric disease.
Trial report in Diabetes, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 95 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
95 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Antipsychotic Drugs and Dysregulated Glucose Homeostasis: A Systematic Review and Meta-Analysis.JAMA psychiatry · 2025Pooled it
- The impacts of antipsychotic medications on eating-related outcomes: A mixed methods systematic review.PloS one · 2025Pooled it
- Relevance of diet in schizophrenia: a review focusing on prenatal nutritional deficiency, obesity, oxidative stress and inflammation.Frontiers in nutrition · 2024Pooled it
- Eating cognitions, emotions and behaviour under treatment with second generation antipsychotics: A systematic review and meta-analysis.Journal of psychiatric research · 2023Pooled it
- The effect of antipsychotic treatment on hormonal, inflammatory, and metabolic biomarkers in healthy volunteers: A systematic review and meta-analysis.Pharmacotherapy · 2022Pooled it
- Atypical antipsychotics, insulin resistance and weight; a meta-analysis of healthy volunteer studies.Progress in neuro-psychopharmacology & biological psychiatry · 2018Pooled it
- Reduction in Multiple Cardiometabolic Risk Factors With Combined Olanzapine/Samidorphan Compared With Olanzapine: Post Hoc Analyses From a 24-Week Phase 3 Study.Schizophrenia bulletin · 2023Trial
- Insulin and glucose metabolism with olanzapine and a combination of olanzapine and samidorphan: exploratory phase 1 results in healthy volunteers.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2022Trial
- Metabolic Effects of Aripiprazole and Olanzapine Multiple-Dose Treatment in a Randomised Crossover Clinical Trial in Healthy Volunteers: Association with Pharmacogenetics.Advances in therapy · 2021Trial
- Contribution of parasympathetic muscarinic augmentation of insulin secretion to olanzapine-induced hyperinsulinemia.American journal of physiology. Endocrinology and metabolism · 2018Trial
- Metabolic Effects of Antipsychotics on Adiposity and Insulin Sensitivity in Youths: A Randomized Clinical Trial.JAMA psychiatry · 2018Trial
- Pathophysiology of drug induced weight and metabolic effects: findings from an RCT in healthy volunteers treated with olanzapine, iloperidone, or placebo.Journal of psychopharmacology (Oxford, England) · 2018Trial
- Review
- Fenofibrate Protects Against Antipsychotic-Induced Hyperglycemia Through Weight Loss and FGF21 Dependent Mechanisms.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2026Article
- Review
- The effect of olanzapine on diabetes related index in humans: a systematic review and meta-analysis of randomized controlled trials.Diabetology & metabolic syndrome · 2026Review
- Correlation between body mass index and health related quality of life among patients with mental disorders.BMC psychiatry · 2025Article
- Atypical antipsychotic drugs cause abnormal glucose and lipid metabolism independent of weight gain.European archives of psychiatry and clinical neuroscience · 2025Article
- Insulin Sensitivity and Insulin Secretion in Adults With Friedreich's Ataxia: The Role of Skeletal Muscle.The Journal of clinical endocrinology and metabolism · 2025Observational
- Olanzapine and peripheral metabolic dysregulation: organ-resolved mechanisms, risk, and MASLD-aligned care pathways.Frontiers in pharmacology · 2025Review
35 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
6 authors.
Funding
Abstract
Atypical antipsychotic (AAP) medications that have revolutionized the treatment of mental illness have become stigmatized by metabolic side effects, including obesity and diabetes. It remains controversial whether the defects are treatment induced or disease related. Although the mechanisms underlying these metabolic defects are not understood, it is assumed that the initiating pathophysiology is weight gain, secondary to centrally mediated increases in appetite. To determine if the AAPs have detrimental metabolic effects independent of weight gain or psychiatric disease, we administered olanzapine, aripiprazole, or placebo for 9 days to healthy subjects (n = 10, each group) under controlled in-patient conditions while maintaining activity levels. Prior to and after the interventions, we conducted a meal challenge and a euglycemic-hyperinsulinemic clamp to evaluate insulin sensitivity and glucose disposal. We found that olanzapine, an AAP highly associated with weight gain, causes significant elevations in postprandial insulin, glucagon-like peptide 1 (GLP-1), and glucagon coincident with insulin resistance compared with placebo. Aripiprazole, an AAP considered metabolically sparing, induces insulin resistance but has no effect on postprandial hormones. Importantly, the metabolic changes occur in the absence of weight gain, increases in food intake and hunger, or psychiatric disease, suggesting that AAPs exert direct effects on tissues independent of mechanisms regulating eating behavior.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.