title: Clozapine and associated diabetes mellitus.
abstract: 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.
authors.affiliation: Psychiatry Service, Cleveland Veterans Affairs Medical Center, Case Western Reserve University School of Medicine, Ohio, USA.
authors.forename: A P
authors.initials: AP
authors.lastname: Popli
authors.forename: P E
authors.initials: PE
authors.lastname: Konicki
authors.forename: G J
authors.initials: GJ
authors.lastname: Jurjus
authors.forename: M A
authors.initials: MA
authors.lastname: Fuller
authors.forename: G E
authors.initials: GE
authors.lastname: Jaskiw
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D003024:Clozapine