Diabetes associated with atypical antipsychotic treatment may be severe but reversible: case report.
OBJECTIVE
To draw attention to severe presentations of atypical neuroleptic related diabetes and to document that a marked degree of remission can take place after drug withdrawal.


METHODS
We describe two patients who presented with diabetic ketoacidosis after treatment with quetiapine and risperidone, respectively.


RESULTS
Both patients were negative for islet cell antibodies. They both required treatment with insulin, one in very high dosage, but their insulin requirements fell progressively after the atypical antipsychotic was withdrawn. After several months, neither patient required antidiabetic treatment.


CONCLUSIONS
Atypical antipsychotic-induced diabetes does not always take a "type 2" presentation in which weight gain and insulin resistance are implicated. Sometimes the presentation is with diabetic ketoacidosis, requiring insulin treatment, which can nevertheless be reversible.
Fulbourn Hospital, Cambridge, UK. clairedibben@zoom.co.uk
C R M
CR
Dibben
S S
SS
Kalavalapalli
H E J
HE
Linnington
F A
FA
Hynes
S F
SF
Dinneen
A I
AI
Adler
P J
PJ
McKenna
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy; D003987:Dibenzothiazepines / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D000069348:Quetiapine Fumarate; D018967:Risperidone / Q000009:adverse effects* / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy*; D012720:Severity of Illness Index
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D007004:Hypoglycemic Agents; D000069348:Quetiapine Fumarate; D008687:Metformin; D018967:Risperidone