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.
Roefaro
J
J
Veterans Affairs Boston Healthcare System, MA 02130-4817, USA. roefaro.john@boston.va.gov
Mukherjee
S M
SM
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