Posts Tagged ‘Luvox’
Disorders and Diabetes
Question. I am a forensic psychiatrist with a special interest in psychopathology and psychiatric disorders associated with diabetes, such as aggression and violence. What is your experience in such cases ? What references can you suggest?
Answer. You are raising an interesting question, which is reviewed nicely in W.A. Lishman’s superb text, Organic Psychiatry, 3rd Edition (Blackwell, 1998). It is difficult to separate psychopathology attributable to diabetes mellitus (DM) from that due to poorly controlled blood sugar, hypoglycemic attacks and subsequent brain damage. For example, a study by Schwandt (1979) found that nine out of 45 unstable diabetics who had been overtreated with insulin showed mood swings, irritability, and chronic fatigue.
Apart from hypoglycemia-related disturbances, it is not clear that diabetes mellitus per se is associated with specific types of psychopathology, although fatigue, depression and irritability have been observed in some surveys. A few studies suggest a higher than expected prevalence of diabetes mellitus in psychiatric hospital populations, but this is usually the late onset, non-insulin-dependent type. Episodes of diabetic coma or hypoglycemia may contribute to brain damage and cognitive deficits, but a causal connection is not clear. There is, finally, some evidence for increased rates of depression (vs. non-diabetic populations) in patients with diabetes mellitus (see the American Psychiatric Press Textbook of Neuropsychiatry, edited by Yudofsky and Hales). Mania, on the other hand, is rare. Diabetics with major depression may benefit from use of SSRIs (Luvox, Paxil, Prozac, Zoloft), since these medications (unlike tricyclics) seem to improve glucose tolerance.