Acute onset clozapine-induced hyperglycaemia: A case report

Abstract

Clozapine is an atypical antipsychotic which is described to have higher efficacy among all available antipsychotic medications. Clozapine is reserved especially for resistant schizophrenia due to its side effects. Clozapine-induced metabolic syndrome and hyperglycaemia are common long-term side effects and are responsible for increased mortality in patients with schizophrenia. In this case, a patient with resistant schizophrenia was presented with acute-onset hyperglycaemia and delirium with the use of clozapine within a week. Withdrawal of clozapine in the patient led to the improvement in delirium and hyperglycaemia without the use of any hypoglycaemic agent. This case supports the notion that in certain cases clozapine can induce hyperglycemia through possible direct pathophysiological mechanisms within a shorter time frame.

Rethinking Clozapine: Lights and Shadows of a Revolutionary Drug

“…The literature includes a report on the case of a 26-year-old man with psychotic symptoms, a BMI of 26, and little abdominal fat who received Clozapine. At day 10 of titration, he reached 200 mg/day and started to experience delirium during the night, ascribed to high glucose levels in the blood, which came back within range after stopping Clozapine [232]. Indeed, the recent literature reported a diabetes diagnosis in up to 26.48% of patients treated with Clozapine and a pre-diabetic state in up to 14.63% after about 6 years of therapy [205].…”

Antipsychotics inhibit the mitochondrial bioenergetics of pancreatic beta cells isolated from CD1 mice

“…APs are classified as either old typical (conventional) or newer atypical APs with different common side effects, including extrapyramidal manifestations, 4 atropine‐like action 5 and metabolic disorders 6 . Since the mid‐1960s, AP treatment was associated with the aggravation of already existing DM or the development of new‐onset type II DM with reported higher risk of hyperglycaemic emergencies 7‐12 …”