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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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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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creator	Howes, Oliver D. Bhatnagar, Ajay Gaughran, Fiona P. Amiel, Stephanie A. Murray, Robin M. Pilowsky, Lyn S.
description	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.
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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.</description><identifier>ISSN: 0002-953X</identifier><identifier>EISSN: 1535-7228</identifier><identifier>DOI: 10.1176/appi.ajp.161.2.361</identifier><identifier>PMID: 14754788</identifier><identifier>CODEN: AJPSAO</identifier><language>eng</language><publisher>Washington, DC: American Psychiatric Publishing</publisher><subject>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. 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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.</description><subject>Adult</subject><subject>Antipsychotic Agents - adverse effects</subject><subject>Biological and medical sciences</subject><subject>Blood Glucose - drug effects</subject><subject>Body Mass Index</subject><subject>Clozapine - adverse effects</subject><subject>Drug therapy</subject><subject>Drug toxicity and drugs side effects treatment</subject><subject>Female</subject><subject>Glucose</subject><subject>Glucose Tolerance Test</subject><subject>Humans</subject><subject>Insulin</subject><subject>Insulin resistance</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metabolic Syndrome - chemically induced</subject><subject>Miscellaneous (drug allergy, mutagens, teratogens...)</subject><subject>Pharmacology. Drug treatments</subject><subject>Prospective Studies</subject><subject>Schizophrenia</subject><subject>Schizophrenia - drug therapy</subject><subject>Severity of Illness Index</subject><issn>0002-953X</issn><issn>1535-7228</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><recordid>eNp9kV1rFDEUhoModlv9A15IELycaT5nkhuhDFoXCoof6F3IZDLdLLPJmGQK669v1l1avfHqEPKc97znvAC8wqjGuG0u9Ty7Wm_nGje4JjVt8BOwwpzyqiVEPAUrhBCpJKc_z8B5StvyRLQlz8EZZi1nrRAr4K_g5xjSbE12dxZ-zcuwh2GE692sXdxZn6Hz8HpaTEgWdsHnGCbY6SXZAfZ72E3ht56dt_CHy5uwZNhttL-16dC29mmZSv1ik0tZe2NfgGejnpJ9eaoX4PuH99-6j9XNp-t1d3VTaSZ5rmxvhoG1jEhKWGOFNIwSSnQvcG-FJlzyoaxoBiuEHtHIRjqy3nBUduqRRPQCvDvqzku_s4Mpe0Q9qTm6nY57FbRT__54t1G34U7RRnDSyCLw5iQQw6_Fpqy2YYm-eFaEINZKSZsCkSNkyglTtOPDAIzUISJ1iEiViFSJSJGijkvT67-tPbacMinA2xOgk9HTGMvhXHrkCiUpZ4W7PHJ_hjzY-8_oe170rZY</recordid><startdate>20040201</startdate><enddate>20040201</enddate><creator>Howes, Oliver D.</creator><creator>Bhatnagar, Ajay</creator><creator>Gaughran, Fiona P.</creator><creator>Amiel, Stephanie A.</creator><creator>Murray, Robin M.</creator><creator>Pilowsky, Lyn S.</creator><general>American Psychiatric Publishing</general><general>American Psychiatric Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>5PM</scope></search><sort><creationdate>20040201</creationdate><title>A Prospective Study of Impairment in Glucose Control Caused by Clozapine Without Changes in Insulin Resistance</title><author>Howes, Oliver D. ; Bhatnagar, Ajay ; Gaughran, Fiona P. ; Amiel, Stephanie A. ; Murray, Robin M. ; Pilowsky, Lyn S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a495t-ebcdd474293246e89c43232ab81be8a2595d228cde88af0f4f3f4bc50788b0903</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Antipsychotic Agents - adverse effects</topic><topic>Biological and medical sciences</topic><topic>Blood Glucose - drug effects</topic><topic>Body Mass Index</topic><topic>Clozapine - adverse effects</topic><topic>Drug therapy</topic><topic>Drug toxicity and drugs side effects treatment</topic><topic>Female</topic><topic>Glucose</topic><topic>Glucose Tolerance Test</topic><topic>Humans</topic><topic>Insulin</topic><topic>Insulin resistance</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metabolic Syndrome - chemically induced</topic><topic>Miscellaneous (drug allergy, mutagens, teratogens...)</topic><topic>Pharmacology. 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source	American Psychiatric Publishing Journals (1997-Present)
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
title	A Prospective Study of Impairment in Glucose Control Caused by Clozapine Without Changes in Insulin Resistance
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