Related Experiment Video
Updated: May 22, 2026
12:08
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Oral aripiprazole-induced severe hypoglycemia
Somnath Mondal1, Indranil Saha, Saibal Das
1Department of Clinical and Experimental Pharmacology, Calcutta School of Tropical Medicine, Kolkata, India.
Therapeutic Drug Monitoring
|May 3, 2012
Summary
A rare adverse drug reaction occurred when aripiprazole caused severe hypoglycemia in a Parkinson's patient. This case highlights the potential for serious blood sugar changes with this antipsychotic medication.
Area of Science:
- Pharmacology
- Clinical Neurology
- Adverse Drug Reactions
Background:
- Parkinson's disease management often involves carbidopa-levodopa.
- Psychosis can co-occur in patients with Parkinson's disease.
- Aripiprazole is an atypical antipsychotic used to treat various psychiatric conditions.
Observation:
- A 72-year-old male with Parkinson's disease was prescribed oral aripiprazole for psychosis.
- The patient developed symptoms of hypoglycemia after 10 days of aripiprazole treatment.
- Hospitalization was required on day 21 due to severe hypoglycemia.
Findings:
- A dechallenge and rechallenge study confirmed a definite link between aripiprazole and hypoglycemia.
- The Naranjo scale classified the adverse drug reaction as "definite".
- Concomitant medications included carbidopa-levodopa, losartan, and rosuvastatin.
Implications:
- Clinicians should be vigilant for hypoglycemia as a potential adverse effect of aripiprazole, especially in elderly patients or those with comorbidities.
- This case underscores the importance of careful drug monitoring and risk assessment when initiating antipsychotic therapy.
- Further research may be warranted to elucidate the mechanism underlying aripiprazole-induced hypoglycemia.
Related Concept Videos
01:29Hyperglycemia
Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
01:26Hypoglycemia
Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
01:19Oral Hypoglycemic Agents: α-Glucosidase Inhibitors
α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are typically...
Acarbose and miglitol are typically...
01:15Hypoglycemia and Glucagon
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
01:26Oral Hypoglycemic Agents: Biguanides and Glitazones
Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood glucose levels...
01:06Oral Hypoglycemic Agents: Glinides
Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively manages...