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Case report
Acute onset clozapine-induced hyperglycaemia: A case report
  1. Pradeep Kumar1,
  2. Dheerendra Kumar Mishra1,
  3. Nimisha Mishra1,
  4. Sunil Ahuja1,
  5. Gyanendra Raghuvanshi1 and
  6. Vijay Niranjan2
  1. 1Department of Psychiatry, Shyam Shah Medical College Rewa, Rewa, India
  2. 2Department of Psychiatry, Mahatma Gandhi Memorial Medical College, Indore, India
  1. Correspondence to Dr Dheerendra Kumar Mishra; mdheerendra.ssmc{at}gmail.com

Abstract

Clozapine is an atypical antipsychotic which is described to have higher efficacy among all available antipsychotic medications. Clozapine is reserved especially for resistant schizophrenia due to its side effects. Clozapine-induced metabolic syndrome and hyperglycaemia are common long-term side effects and are responsible for increased mortality in patients with schizophrenia. In this case, a patient with resistant schizophrenia was presented with acute-onset hyperglycaemia and delirium with the use of clozapine within a week. Withdrawal of clozapine in the patient led to the improvement in delirium and hyperglycaemia without the use of any hypoglycaemic agent. This case supports the notion that in certain cases clozapine can induce hyperglycemia through possible direct pathophysiological mechanisms within a shorter time frame.

  • clozapine
  • adverse effects
  • hyperglycemia
  • delirium
  • acute onset

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0

https://doi.org/10.1136/gpsych-2018-100045

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    Footnotes

    • Contributors PK and DM contributed to the observations and conceptualise the case. NM, SA and GR contributed to the detailed assessment, evaluation and conclude the case. DM and VN contributed to the manuscript writing, proof reading and literature review.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.