Olanzapine-lnduced hyperglycemic nonketonic coma.
OBJECTIVE
To report a case of olanzapine-induced hyperglycemia leading to a hyperosmolar, hyperglycemic, nonketonic coma.


METHODS
A 51-year-old, 85.5-kg (ideal body weight 79.9 kg), white man presented to a Veterans Affairs hospital with a serum glucose concentration of 1596 mg/dL. Soon thereafter, he went into a hyperosmolar, hyperglycemic, nonketonic coma. Olanzapine therapy had been instituted less than six months prior to this event; approximately two months before this event, his blood glucose was 108 mg/dL. Eight days after stopping olanzapine, the glucose concentration returned to normal, and the patient no longer required insulin nor any other glucose-lowering agents.


CONCLUSIONS
The insulin resistance caused by olanzapine is normally attributed to the weight gain associated with the drug. In this patient, it appears that olanzapine caused hyperglycemia by a mechanism other than weight gain.


CONCLUSIONS
This case report and others from the literature suggest that olanzapine therapy may induce hyperglycemia in some patients.
Veterans Affairs Boston Healthcare System, MA 02130-4817, USA. roefaro.john@boston.va.gov
J
J
Roefaro
S M
SM
Mukherjee
D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines; D001714:Bipolar Disorder / Q000188:drug therapy; D001786:Blood Glucose / Q000378:metabolism; D006801:Humans; D006944:Hyperglycemic Hyperosmolar Nonketotic Coma / Q000097:blood / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D010890:Pirenzepine / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy
D014150:Antipsychotic Agents; D001786:Blood Glucose; D001569:Benzodiazepines; D010890:Pirenzepine; D000077152:Olanzapine