Shridhar Sharma: Insulin coma treatment – Facts and controversies

Hector Warnes’ response to Shridhar Sharma’s reply

            Professor Sharma has written an excellent overview of the relation of schizophrenia and glucose metabolism. He went further to mention the effect of antipsychotic drugs on glucose metabolism and weight gain. I would like to add a more specific disorder that has been called "the metabolic syndrome" which has been found with greater frequency in schizophrenics treated with clozapine and olanzapine as compared with those treated with haloperidol. This syndrome consists of hyperinsulinemia, insulin resistance, weight gain, impaired glucose metabolism and dyslipidemia and is considered a early warning sign of a type II diabetes. Significant weight gain in itself is considered a risk factor for hypertension and coronary arteriopathy. I would add that sedentarism and smoking habits may also play a role. It has been shown that the schizophrenic population has a higher inclination to smoke than the general population. Smoking increases nicotinic cholinergic neurotransmission, but may also have other interactions with atypical anti-psychotic medication.

            Professor Sharma has made a great contribution to a topic which was largely ignored in schizophrenia research.

Hector Warnes

January 10, 2017