title: Physical complications in early clozapine treatment: a case report and implications for safe monitoring.
abstract: Treatment with the antipsychotic clozapine is often complicated by its wide-ranging and sometimes serious adverse effect profile. A link between clozapine therapy and diabetes is well established, although the onset and severity of glucose metabolism abnormalities is variable. Recent literature also suggests there may be an association between clozapine therapy and pneumonia. We review the relevant background literature and present a case of a patient with pre-existing type 2 diabetes mellitus and chronic obstructive pulmonary disease who presented with a diabetic emergency after a relatively short period of treatment with clozapine. He went on to develop pneumonia from which he died. We discuss the implications this case, and others alike, have for early routine physical health monitoring of this patient group.
authors: Department of Psychosis Studies, Institute of Psychiatry, London, UK.
authors: Sachin S
authors: SS
authors: Patel
authors: Matthew P G
authors: MP
authors: Allin
keywords: clozapine; diabetes; monitoring; pneumonia; schizoaffective disorder; schizophrenia
references: Curr Diab Rep. 2010 Jun;10(3):209-16
references: 20425584
references: Am J Med. 2001 Dec 15;111(9):716-23
references: 11747852
references: J Psychopharmacol. 2005 Nov;19(6 Suppl):56-65
references: 16280338
references: Am J Psychiatry. 2004 Feb;161(2):361-3
references: 14754788
references: Ann Clin Psychiatry. 2007 Apr-Jun;19(2):105-12
references: 17612850
references: Pharmacopsychiatry. 2004 May;37(3):134-8
references: 15138897
references: Diabetes Care. 2004 Feb;27(2):596-601
references: 14747245
references: J Clin Psychiatry. 2005 Sep;66(9):1116-21
references: 16187768
references: Br J Psychiatry. 2009 Feb;194(2):165-7
references: 19182180
references: CNS Drugs. 2007;21(2):117-27
references: 17284094
references: J Clin Psychopharmacol. 1996 Dec;16(6):462-3
references: 8959476
references: J Am Geriatr Soc. 2008 Apr;56(4):661-6
references: 18266664
references: CNS Drugs. 2005;19 Suppl 1:1-93
references: 15998156
references: Ann Intern Med. 2010 Apr 6;152(7):418-25, W139-40
references: 20368647
references: J Psychopharmacol. 2005 Mar;19(2):207-10
references: 15728442