Content area
Full text
Clozapine is an atypical antipsychotic drug used for the management of psychotic disorders in patients who cannot tolerate or do not respond to traditional neuroleptics. Serious adverse effects include hematologic deficiencies, sedation, seizures, sialorrhea, weight gain, and orthostatic hypotension. Some cases of severe hyperglycemia have been recently reported (1-4). We report a 31-year-old Caucasian man affected by schizoaffective disorder, bipolar type, who developed diabetic ketoacidosis while on clozapine.
The patient started 3 months before admission (October 1997) on a regimen of 200 mg of clozapine daily to control repeated psychotic episodes refractory to treatment with traditional neuroleptics. No concomitant drug was assumed. He was found to be obtunded and dehydrated. Laboratory data showed severe hyperglycemia (42 mmol/1), acidosis (pH 6.9, HCO^sub 3^ 3.1 mmol), and hyperosmolality (Na 153 mmol/l, K 3 mmol, blood urea nitrogen 38.2 mmol/l); serum and urinary ketones were positive. He had no family or prior history, and no laboratory evidence of diabetes or glucose intolerance. His BMI was 29 kg/m2, and...