Clozapine-associated Diabetes Mellitus and Hyperlipidemia

Clozapine引起糖尿病和高血脂症

10.29478/TJP.200509.0009

林志強(Jyh-Chyang Lin)；夏一新(I-Shin Shiah)；諶立中(Lih-Jong Shen)；楊延壽(Yen-Shou Yang)

Clozapine ； 糖尿病 ； 高血糖 ； 高血脂 ； clozapine ； diabetes mellitus ； hyperglycemia ； hyperlipidemia

台灣精神醫學

19卷3期（2005 / 09 / 01）

244 - 249

英文

目的：本文報告一位精神分裂症患者服用clozapine三年，產生新發作的糖尿病和高血脂症。個案報告：一位三十九歲女性慢性精神分裂症患者，曾多次精神科住院，接受多種第一代抗精神病藥物、第二代抗精神病藥物risperidone及二十次電療。這些治療並未造成患者產生糖尿病或高血脂症。之後該患者接受clozapine（每日三百毫克）三年的治療，雖其病況改善，但卻出現糖尿病和高血脂症。目前她仍需持續服用抗糖尿病及抗血脂藥物。結論：本文個案顯示以clozapine治療精神分裂病患者，需早期發現高血糖和高血脂症。

Objective: We report a schizophrenic woman who developed new-onset diabetes mellitus (DM) and hyperlipidemia after having taken clozapine for three years. Case Report: A 39-year-old Hakka woman with chronic schizophrenia who had multiple hospitalizations for acute psychiatric symptoms, had been treated with flupenthixol, sulpiride, clopenthixol, risperidone, flupenthixol depot injection, and 20 treatments with bilateral electroconvulsive therapy (ECT). These treatments had not caused DM or hyperlipidemia. However, her treatment was later modified and clozapine (300 mg/d) was started. Although the addition of clozapine improved her psychotic symptoms, she developed new-onset DM and hyperlipidemia three years later. At last follow up in April of 2005, she required antidiabetic and antilipid medications for controlling DM and hyperlipidemia. Conclusion: The findings of this case stress the importance of early recognition of developing hyperglycemia and hyperlipidemia when schizophrenic patients are treated with clozapine.

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