Kumar Pradeep, Mishra Dheerendra Kumar, Mishra Nimisha, Ahuja Sunil, Raghuvanshi Gyanendra, Niranjan Vijay
Department of Psychiatry, Shyam Shah Medical College Rewa, Rewa, India.
Department of Psychiatry, Mahatma Gandhi Memorial Medical College, Indore, India.
Gen Psychiatr. 2019 Apr 11;32(2):e100045. doi: 10.1136/gpsych-2018-100045. eCollection 2019.
Clozapine is an atypical antipsychotic which is described to have higher efficacy among all available antipsychotic medications. Clozapine is reserved especially for resistant schizophrenia due to its side effects. Clozapine-induced metabolic syndrome and hyperglycaemia are common long-term side effects and are responsible for increased mortality in patients with schizophrenia. In this case, a patient with resistant schizophrenia was presented with acute-onset hyperglycaemia and delirium with the use of clozapine within a week. Withdrawal of clozapine in the patient led to the improvement in delirium and hyperglycaemia without the use of any hypoglycaemic agent. This case supports the notion that in certain cases clozapine can induce hyperglycemia through possible direct pathophysiological mechanisms within a shorter time frame.
氯氮平是一种非典型抗精神病药物，在所有可用的抗精神病药物中疗效较高。由于其副作用，氯氮平特别适用于难治性精神分裂症。氯氮平诱发的代谢综合征和高血糖是常见的长期副作用，也是精神分裂症患者死亡率增加的原因。在本病例中，一名难治性精神分裂症患者在使用氯氮平一周内出现急性高血糖和谵妄。该患者停用氯氮平后，谵妄和高血糖症状得到改善，且未使用任何降糖药物。该病例支持了这样一种观点，即在某些情况下，氯氮平可通过可能的直接病理生理机制在较短时间内诱发高血糖。
