Popli A P, Konicki P E, Jurjus G J, Fuller M A, Jaskiw G E
Psychiatry Service, Cleveland Veterans Affairs Medical Center, Case Western Reserve University School of Medicine, Ohio, USA.
J Clin Psychiatry. 1997 Mar;58(3):108-11. doi: 10.4088/jcp.v58n0304.
Clozapine is an effective therapy for the treatment of refractory psychosis. Clozapine-associated adverse effects include sedation, weight gain, sialorrhea, palpitations, seizures, and hematologic changes such as agranulocytosis.
We present a four-case series in which clozapine use was associated with either a de novo onset or severe exacerbation of preexisting diabetes mellitus.
The change in glycemic control was not significantly related to weight gain. Three of the patients have been able to continue on clozapine therapy and have experienced a reduction in psychotic symptoms.
Patients with a family history of diabetes mellitus or with preexisting diabetes mellitus may need to have blood sugar monitored closely during initiation of clozapine treatment.
氯氮平是治疗难治性精神病的有效疗法。氯氮平相关的不良反应包括镇静、体重增加、流涎、心悸、癫痫发作以及血液学变化，如粒细胞缺乏症。
我们报告了一个包含4例病例的系列，其中氯氮平的使用与新发糖尿病或原有糖尿病的严重加重有关。
血糖控制的变化与体重增加无显著相关性。3例患者能够继续接受氯氮平治疗，且精神病症状有所减轻。
有糖尿病家族史或原有糖尿病的患者在开始氯氮平治疗期间可能需要密切监测血糖。
