Clozapine and associated diabetes mellitus.
BACKGROUND
Clozapine is an effective therapy for the treatment of refractory psychosis. Clozapine-associated adverse effects include sedation, weight gain, sialorrhea, palpitations, seizures, and hematologic changes such as agranulocytosis.


METHODS
We present a four-case series in which clozapine use was associated with either a de novo onset or severe exacerbation of preexisting diabetes mellitus.


RESULTS
The change in glycemic control was not significantly related to weight gain. Three of the patients have been able to continue on clozapine therapy and have experienced a reduction in psychotic symptoms.


CONCLUSIONS
Patients with a family history of diabetes mellitus or with preexisting diabetes mellitus may need to have blood sugar monitored closely during initiation of clozapine treatment.
Popli
A P
AP
Psychiatry Service, Cleveland Veterans Affairs Medical Center, Case Western Reserve University School of Medicine, Ohio, USA.
Konicki
P E
PE
Jurjus
G J
GJ
Fuller
M A
MA
Jaskiw
G E
GE
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003024:Clozapine / Q000009:adverse effects* / Q000627:therapeutic use; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000139:chemically induced*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology; D018149:Glucose Intolerance / Q000139:chemically induced; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000097:blood / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome
D001786:Blood Glucose; D003024:Clozapine