Muench J, Carey M
Department of Family Medicine, Oregon Health Sciences University, Portland 97201, USA.
J Am Board Fam Pract. 2001 Jul-Aug;14(4):278-82.
Since the introduction of atypical antipsychotic medications, beginning with clozapine in 1990, several case reports in the psychiatric literature have suggested that they might be associated with new onset of diabetes mellitus as well as with diabetic ketoacidosis.
We report the case of a 38-year-old patient with schizophrenia who suddenly developed diabetes mellitus and ketoacidosis 12 months after starting olanzapine. Similar cases in the literature were found through a MEDLINE-assisted search using the key words "schizophrenia," "diabetes mellitus," "ketoacidosis," and "adverse drug reaction."
Including this case, 30 patients have been reported in the literature to have developed diabetes or have lost diabetic control after starting clozapine, olanzapine, or quetiapine. Twelve of these 30 developed diabetic ketoacidosis. Two limited quantitative studies have added evidence toward this association.
Although a causal relation has not been definitively proved, the number of cases reported in the literature suggests there might be an association between atypical antipsychotic medications and diabetes mellitus. Primary care physicians who care for patients with schizophrenia should be aware of this possible association.
自1990年氯氮平首次引入非典型抗精神病药物以来，精神病学文献中的几例病例报告表明，这些药物可能与新发糖尿病以及糖尿病酮症酸中毒有关。
我们报告了一例38岁的精神分裂症患者，在开始使用奥氮平12个月后突然患上糖尿病和酮症酸中毒。通过使用关键词“精神分裂症”“糖尿病”“酮症酸中毒”和“药物不良反应”在MEDLINE辅助检索中查找文献中的类似病例。
包括本病例在内，文献报道有30例患者在开始使用氯氮平、奥氮平或喹硫平后患上糖尿病或糖尿病病情失控。这30例中有12例发生了糖尿病酮症酸中毒。两项有限的定量研究为这种关联提供了更多证据。
尽管尚未明确证实因果关系，但文献中报道的病例数量表明非典型抗精神病药物与糖尿病之间可能存在关联。治疗精神分裂症患者的初级保健医生应意识到这种可能的关联。
