title: Diabetic ketoacidosis and severe hypertriglyceridaemia as a consequence of an atypical antipsychotic agent.
abstract: The atypical antipsychotic agent clozapine, although an effective treatment for schizophrenia, is linked with metabolic adverse effects. We report a case of diabetic ketoacidosis and very severe hypertriglyceridaemia associated with clozapine use, in a patient with type 2 diabetes mellitus, who was successfully treated with continuous insulin infusion and fluids. As clozapine proved to be the most efficacious in controlling the patient's psychotic symptoms, the patient has been continued on clozapine despite its known metabolic side effects. Importantly the patient has achieved satisfactory long-term lipid and glycaemic control. The current recommendations related to the metabolic care for patients treated with atypical antipsychotic agents as well as the mechanisms behind abnormal glucose and lipid regulation with clozapine therapy are discussed.
authors: Endocrinology Department, Sutherland Hospital, Caringbah, New South Wales, Australia.
authors: Kirsten
authors: K
authors: Hepburn
authors: Endocrinology Department, Sutherland Hospital, Caringbah, New South Wales, Australia St George & Sutherland Hospital Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
authors: Malgorzata Monika
authors: MM
authors: Brzozowska
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects*; D003024:Clozapine / Q000009:adverse effects*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D016883:Diabetic Ketoacidosis / Q000139:chemically induced*; D005440:Fluid Therapy; D006801:Humans; D015228:Hypertriglyceridemia / Q000139:chemically induced*; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D011618:Psychotic Disorders / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D007004:Hypoglycemic Agents; D007328:Insulin; D003024:Clozapine