Q. My son is diagnosed bipolar 2, and is currently on abilify (a specific for bipolar 1, and an increased risk for diabetes) and effexor. Can you suggest other medications specific for bipolar 2 that do not increase his diabetes risk that I might research?

A. The problem is that most of the atypical antipsychotic medications (which is the type of medication that Ability is classified as) tend to increase an individual’s risk for type II diabetes, known formally as adult onset diabetes. Some medications are thought to be better than others.

Recently, a panel of endocrinologists and psychiatrists published a rank ordered list of atypical antipsychotic medications. They ranked them in order from greatest to the least risk on metabolic effects. Olanzapine (Zyprexa) was thought to have the greatest effect on metabolic health, followed by quetiapine (Seroquel), risperidone (Risperdal), and ziprasidone (Geodon). Aripiprazole (Abilify) was thought to pose the least risk to metabolic health. You can find out more by visiting http://care.diabetesjournals.org/cgi/content/full/26/5/1597/T3:

There is no evidence that atypical antipsychotic medications cause diabetes type II but there does seem to be a link, albeit an unclear link. Individuals who take atypical antipsychotic medications should take them only under the supervision of a trained psychiatrist or physician who is committed to monitoring a patient’s metabolic health. If you or your son notices that Abilify is causing him to gain weight or experience an increase in his insulin levels then it may be time to consider a medication switch.

There is a new atypical antipsychotic medication available called Invega. I am not sure, however, if this medication has been approved for the treatment of bipolar type II. There is not much data available on this medication yet but I have worked with individuals who have taken this medication on very low doses and were able to maintain relatively healthy blood sugar levels.

Please keep in mind that medication works differently for each individual. A medication can work really well for one person and wreak havoc for another. Finding the right medication is more of an art rather than a science. It is usually a trial and error process. Take care and good luck.

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Last reviewed: By John M. Grohol, Psy.D. on 24 Oct 2007

APA Reference
Randle, K. (2007). Antipsychotic medications that don’t cause diabetes type II. Psych Central. Retrieved on November 24, 2014, from http://psychcentral.com/ask-the-therapist/2007/10/24/antipsychotic-medications-that-dont-cause-diabetes-type-ii/