BACKGROUND: Diabetic ketoacidosis (DKA) has been associated with clozapine. The purpose of this study is to examine the clinical-demographic correlates of DKA among outpatients receiving clozapine. METHODS: A literature search was conducted from 1966 to present using Medline to identify 23 case reports of clozapine-associated DKA. In addition, a cohort of twenty-six patients with clozapine-associated diabetes at the University of Rochester Medical Center Department of Psychiatry were examined for histories of DKA through review of medical records. Based on a total sample of 26 case reports including three unpublished cases at University of Rochester, associations between clinical and demographic variables and DKA were examined. RESULTS: African American patients were significantly more likely than other patients to have DKA (p < 0.0001). Clozapine treatment duration was significantly shorter among patients with DKA than those without DKA (p < 0.0001), with 61.5% of patients developing DKA within three months of clozapine initiation. Also, presence of antidiabetic medications was negatively correlated with DKA (p < 0.0001). Trends were noted toward an association between low doses of clozapine (p < 0.0583) and toward a negative association between family history of diabetes (p < 0.0696). CONCLUSION: Clozapine is associated with DKA that usually presents in patients who have not previously been diagnosed with diabetes. DKA typically occurs early in the course of treatment, when clozapine treatment duration is short and doses are low.
BACKGROUND:Diabetic ketoacidosis (DKA) has been associated with clozapine. The purpose of this study is to examine the clinical-demographic correlates of DKA among outpatients receiving clozapine. METHODS: A literature search was conducted from 1966 to present using Medline to identify 23 case reports of clozapine-associated DKA. In addition, a cohort of twenty-six patients with clozapine-associated diabetes at the University of Rochester Medical Center Department of Psychiatry were examined for histories of DKA through review of medical records. Based on a total sample of 26 case reports including three unpublished cases at University of Rochester, associations between clinical and demographic variables and DKA were examined. RESULTS: African American patients were significantly more likely than other patients to have DKA (p < 0.0001). Clozapine treatment duration was significantly shorter among patients with DKA than those without DKA (p < 0.0001), with 61.5% of patients developing DKA within three months of clozapine initiation. Also, presence of antidiabetic medications was negatively correlated with DKA (p < 0.0001). Trends were noted toward an association between low doses of clozapine (p < 0.0583) and toward a negative association between family history of diabetes (p < 0.0696). CONCLUSION:Clozapine is associated with DKA that usually presents in patients who have not previously been diagnosed with diabetes. DKA typically occurs early in the course of treatment, when clozapine treatment duration is short and doses are low.
Authors: Domenico De Berardis; Gabriella Rapini; Luigi Olivieri; Domenico Di Nicola; Carmine Tomasetti; Alessandro Valchera; Michele Fornaro; Fabio Di Fabio; Giampaolo Perna; Marco Di Nicola; Gianluca Serafini; Alessandro Carano; Maurizio Pompili; Federica Vellante; Laura Orsolini; Giovanni Martinotti; Massimo Di Giannantonio Journal: Ther Adv Drug Saf Date: 2018-02-06
Authors: Rebecca N Jerome; Jill M Pulley; Nila A Sathe; Shanthi Krishnaswami; Alyssa B Dickerson; Katherine J Worley; Consuelo H Wilkins Journal: Ethn Dis Date: 2020-04-02 Impact factor: 1.847
Authors: Marc DE Hert; Christoph U Correll; Julio Bobes; Marcelo Cetkovich-Bakmas; Dan Cohen; Itsuo Asai; Johan Detraux; Shiv Gautam; Hans-Jurgen Möller; David M Ndetei; John W Newcomer; Richard Uwakwe; Stefan Leucht Journal: World Psychiatry Date: 2011-02 Impact factor: 49.548