A Prospective Study of Impairment in Glucose Control Caused by Clozapine Without Changes in Insulin Resistance

OBJECTIVE: This prospective study examines the effect of clozapine on glucose control and insulin sensitivity. METHOD: Glucose homeostasis was measured in nine female and 11 male patients with schizophrenia (mean age=30.5 years, SD=7.4) before clozapine treatment and after a mean of 2.5 months (SD=0...

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Bibliographic Details
Published in:The American journal of psychiatry 2004-02, Vol.161 (2), p.361-363
Main Authors: Howes, Oliver D., Bhatnagar, Ajay, Gaughran, Fiona P., Amiel, Stephanie A., Murray, Robin M., Pilowsky, Lyn S.
Format: Article
Language:English
Subjects:
Adult
Antipsychotic Agents - adverse effects
Biological and medical sciences
Blood Glucose - drug effects
Body Mass Index
Clozapine - adverse effects
Drug therapy
Drug toxicity and drugs side effects treatment
Female
Glucose
Glucose Tolerance Test
Humans
Insulin
Insulin resistance
Male
Medical sciences
Metabolic Syndrome - chemically induced
Miscellaneous (drug allergy, mutagens, teratogens...)
Pharmacology. Drug treatments
Prospective Studies
Schizophrenia
Schizophrenia - drug therapy
Severity of Illness Index
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Summary:OBJECTIVE: This prospective study examines the effect of clozapine on glucose control and insulin sensitivity. METHOD: Glucose homeostasis was measured in nine female and 11 male patients with schizophrenia (mean age=30.5 years, SD=7.4) before clozapine treatment and after a mean of 2.5 months (SD=0.95) of clozapine treatment. Oral glucose tolerance and insulin levels were measured. Insulin resistance level was measured by the homeostasis model assessment. RESULTS: Eleven (55%) of the patients developed abnormal glucose control; the mean age of these patients was 30.2 (SD=7.1), and five were women. Patients' insulin resistance at baseline (mean insulin resistance level=3.88, SD=2.93) was unaffected by clozapine. Mean fasting and 2-hour glucose levels significantly increased by 0.55 mmol liter and 1.4 mmol liter, respectively. There was no correlation between change in body mass index and change in fasting glucose levels. CONCLUSIONS: Clozapine impairs glucose control within 4 months of treatment, independent of changes in insulin sensitivity and body mass index.
ISSN:0002-953X
1535-7228
DOI:10.1176/appi.ajp.161.2.361