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Diabetic ketoacidosis associated with aripiprazole
Zaineb H Makhzoumi1, Leon P McLean, Jefferson H Lee
1School of Medicine, University of Maryland, Baltimore, Maryland, USA.
Pharmacotherapy
|August 30, 2008
Summary
Aripiprazole, an atypical antipsychotic, can trigger diabetic ketoacidosis (DKA) even in patients without diabetes history. Close monitoring for hyperglycemia is vital when prescribing this medication.
Area of Science:
- Neuroscience
- Endocrinology
- Pharmacology
Background:
- Atypical antipsychotics are associated with metabolic adverse effects, including hyperglycemia.
- Hyperglycemia can lead to severe complications like diabetic ketoacidosis (DKA) or hyperosmolar coma.
- Aripiprazole, approved in 2002, was thought to have a lower risk of metabolic complications.
Observation:
- A 44-year-old male with no prior diabetes history developed DKA two weeks after starting aripiprazole for schizoaffective disorder.
- The patient's DKA was successfully treated with insulin and hydration.
- No other cause for DKA was identified.
Findings:
- Aripiprazole was identified as the probable cause of DKA using the Naranjo scale.
- This case challenges the perception of aripiprazole having minimal metabolic adverse effects.
- Impaired glucose tolerance should prompt discontinuation of aripiprazole or other atypical antipsychotics.
Implications:
- Clinicians must maintain vigilance for hyperglycemia and DKA in patients on atypical antipsychotics, including aripiprazole.
- Early detection and intervention are crucial to prevent life-threatening outcomes.
- Further research into the metabolic risks of newer antipsychotics is warranted.
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