Severe hyperglycemia induced by olanzapine was improved with a recovery of insulin secretion after switching to risperidone and introducing insulin therapy.
A 35-year-old woman, diagnosed as schizophrenia and treated with olanzapine for nearly 30 months, consulted our department because of severe hyperglycemia. The use of antipsychotics, switching from olanzapine to risperidone, and a one-month introduction of insulin therapy resulted in the decrease of pre-prandial blood glucose levels and the increase of insulin levels (269 to 128 mg/dL, 5.6 to 21.8 µU/mL). A higher level of insulin resistance as measured by HOMA-IR after the improvement of hyperglycemia (3.6 vs. 6.8) suggested that the long use of olanzapine reduced insulin secretion. Based on this case, impairment of pancreatic β-cells caused by olanzapine might be reversible.
Department of Psychiatric Internal Medicine, Kosekai-Kusatsu Hospital, Hiroshima. kusatsu-hp@cosmos.ocn.ne.jp
Masaru
M
Nakamura
Takahiko
T
Nagamine
D000328:Adult; D001569:Benzodiazepines / Q000009:adverse effects*; D057915:Drug Substitution; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy*; D007328:Insulin / Q000378:metabolism* / Q000627:therapeutic use*; D000078790:Insulin Secretion; D000077152:Olanzapine; D020127:Recovery of Function / Q000187:drug effects / Q000502:physiology; D018967:Risperidone / Q000627:therapeutic use*; D012720:Severity of Illness Index
D007328:Insulin; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine