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Acute onset clozapine-induced hyperglycaemia: A case report
Pradeep Kumar1, Dheerendra Kumar Mishra1, Nimisha Mishra1
1Department of Psychiatry, Shyam Shah Medical College Rewa, Rewa, India.
General Psychiatry
|June 11, 2019
Summary
Clozapine, an effective antipsychotic for resistant schizophrenia, can rapidly induce hyperglycemia and delirium. Stopping clozapine improved these symptoms, suggesting a direct link and potential for faster patient recovery.
Area of Science:
- Psychiatry
- Pharmacology
- Endocrinology
Background:
- Clozapine is a highly effective atypical antipsychotic for treatment-resistant schizophrenia.
- Metabolic syndrome and hyperglycemia are known, but typically long-term, side effects of clozapine.
- These side effects contribute to increased mortality in schizophrenia patients.
Observation:
- A patient with treatment-resistant schizophrenia developed acute hyperglycemia and delirium within a week of starting clozapine.
- The patient's symptoms resolved rapidly after clozapine withdrawal.
- No hypoglycemic agents were required for symptom resolution.
Findings:
- This case demonstrates that clozapine can induce acute hyperglycemia and delirium in a short timeframe.
- The rapid improvement upon clozapine cessation suggests a direct pathophysiological mechanism.
- This highlights the importance of vigilant monitoring for metabolic disturbances during clozapine initiation.
Implications:
- Clinicians should consider the potential for rapid-onset hyperglycemia with clozapine, even in the short term.
- Early recognition and drug withdrawal may prevent severe metabolic complications.
- Further research into the acute mechanisms of clozapine-induced hyperglycemia is warranted.
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