CLOZAPINE-INDUCED DIABETIC KETOACIDOSIS: A CASE REPORT

Authors

  • Soumya Mary Alex Department of Clinical Pharmacy, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, India.
  • Vidya P Menon Department of Medicine/Medical Administration, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, India.
  • Sabarish B Department of Emergency Medicine and Critical Care, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, India.
  • Umadevi P Department of Clinical Pharmacy, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, India.
  • Dipu T s Department of Medicine/Medical Administration, Amrita Institute of Medical Sciences andResearch Centre, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, India.

DOI:

https://doi.org/10.22159/ajpcr.2018.v11i3.19140

Keywords:

Clozapine, Diabetic ketoacidosis, Type 2 diabetes, Antipsychoticajpcr2018v11i3

Abstract

 The objective of this study was to report a case of a person with psychiatric illness treated with clozapine presented with diabetic ketoacidosis (DKA). A clinical monitoring was done on a 38-year-old Indian man affected by schizoaffective disorder, bipolar type presented with DKA after 3 months of clozapine therapy (250 mg/day). After treatment of DKA and discontinuation of clozapine, the patient improved symptomatically, his blood sugar levels normalized and insulin requirements also decreased. This report thus highlights that clinicians should be vigilant about the potential risk of new-onset diabetes and DKA in patients taking clozapine and utilize appropriate clinical and laboratory monitoring early in the course of treatment to prevent serious adverse effects.

Downloads

Download data is not yet available.

Author Biography

Soumya Mary Alex, Department of Clinical Pharmacy, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, Kerala, India.

department of internal medicine

clinical pharmacist

 

B.PHARM,PHARM.D

References

US Prescribing Information of CLOZARIL® (clozapine) Tablets, for Oral Use; 2014. Available from: https://www.pharma.us.novartis.com/ product/pi/pdf/Clozaril.pdf. [Last accessed on 2014 Sep ???].

Jin H, Meyer JM, Jeste DV. Phenomenology of and risk factors for new-onset diabetes mellitus and diabetic ketoacidosis associated with atypical antipsychotics: An analysis of 45 published cases. Ann Clin Psychiatry 2002;14:59-64.

Henderson DC, Cagliero E, Copeland PM, Louie PM, Borba CP, Fan X, et al. Elevated hemoglobin A1c as a possible indicator of diabetes mellitus and diabetic ketoacidosis in schizophrenia patients receiving atypical antipsychotics. J Clin Psychiatry 2007;68:533-41.

Nihalani ND, Tu X, Lamberti JS, Olson D, Olivares T, Costea GO, et al. Diabetic ketoacidosis among patients receiving clozapine: A case series and review of socio-demographic risk factors. Ann Clin Psychiatry 2007;19:105-12.

Yadav M, Parle M, Kadian M, Sharma K. A review on psychosis and antipsychotic plants. Asian J Pharm Clin Res 2015;8:24-8.

Jin H, Meyer JM, Jeste DV. Atypical antipsychotics and glucose dysregulation: A systematic review. Schizophr Res 2004;71:195-212.

Ai D, Roper TA, Riley JA. Diabetic ketoacidosis and clozapine. Postgrad Med J 1998;74:493-4.

Vishnupriya R, Ezhilramya J, Meenakshi B. Metformmin in the prevention of metabolic syndrome associated with initiation of atypical antipsychotic therapy in adolescents and young adults-A randomized, open labelled, Single centered study. Int J Pharm Pharm Sci 2016;8:200-6.

Kasmi Y. A case of clozapine induced diabetic ketoacidosis. Psychiatrist Online 2013;37:36.

Colli A, Cocciolo M, Francobandiera F, Rogantin F, Cattalini N. Diabetic ketoacidosis associated with clozapine treatment. Diabetes Care 1999;22:176-7.

Lafayette JM, Pirl WF, Henderson DC. Low-dose clozapine and diabetic ketoacidosis. Psychosomatics 2003;44:249-52.

Avram AM, Patel V, Taylor HC, Kirwan JP, Kalhan S. Euglycemic clamp study in clozapine-induced diabetic ketoacidosis. Ann Pharmacother 2001;35:1381-7.

Published

01-03-2018

How to Cite

Alex, S. M., V. P. Menon, S. B, U. P, and D. T s. “CLOZAPINE-INDUCED DIABETIC KETOACIDOSIS: A CASE REPORT”. Asian Journal of Pharmaceutical and Clinical Research, vol. 11, no. 3, Mar. 2018, pp. 1-2, doi:10.22159/ajpcr.2018.v11i3.19140.

Issue

Section

Case Study(s)