An Archival, Follow-Forward Exploration of the Metabolic Syndrome in Randomly Selected, Clozapine-Treated Patients

Josiassen, Richard C.; Filmyer, Dawn M.; Curtis, Jessica; Shaughnessy, Rita A.; Joseph, Adlai; Parson, Ronald L.; Kacso, Margit; Fedde, Jason D.; Cornelius, Maurice D.; Joseph, M C; Weinstein, Jonathan; Skuban, Nina; Victor, Tim

doi:10.3371/csrp.3.2.3

Cited by 10 publications

(14 citation statements)

References 36 publications

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“…The findings from this study are consistent with those from previous research, linking metabolic syndrome to clozapine treatment [4,5,7] in other population groups. These results reiterate the necessity to monitor weight and BMI in patients receiving clozapine treatment.…”

Section: Resultssupporting

confidence: 83%

“…This agrees with previous studies on other ethnic group patients treated with clozapine, where similarly high prevalences were reported. [4,5,7] The association between BMI and metabolic syndrome illustrated here indicates that BMI may predict metabolic syndrome in clozapine users of Xhosa descent. It has been hypothesised that weight gain is the most significant contributing factor to the development of metabolic syndrome [5] and therefore the BMI may offer a screening test for metabolic syndrome in patients treated with clozapine.…”

Section: Discussionmentioning

confidence: 99%

“…[1] It has long been known that clozapine is associated with weight gain [3] and more recently it has also been shown that there is an increased risk among clozapine users for developing metabolic syndrome. [4][5][6][7] It has been suggested that clozapine may have a direct effect on glucose regulation, independent of weight gain, [8] and Koller et al [2] suggested a causal relationship between clozapine treatment and diabetes.…”

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confidence: 99%

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Undiagnosed metabolic syndrome and other adverse effects among clozapine users of Xhosa descent

et al. 2014

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Section: Resultssupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Undiagnosed metabolic syndrome and other adverse effects among clozapine users of Xhosa descent

et al. 2014

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“…There are very few case reports[ 3 4 5 6 7 ] and few studies suggest an association between clozapine and hypertension. [ 8 9 10 ] The case reports which have suggested association of clozapine with hypertension suggest that it usually occurs during the initial phase of treatment with the doses varying from 62.5 to 250 mg/day. [ 3 4 5 6 7 ] In the index case, hypertension was noted with clozapine 100 mg/day.…”

Section: Discussionmentioning

confidence: 99%

Clozapine-induced hypertension: A case report and review of literature

Grover

Mahajan

2017

Ind Psychiatry J

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There are very few reports which suggest an association between clozapine and hypertension. We report a case in which a direct link of initiation of clozapine to development of hypertension which required pharmacological intervention. A 32-year-old male who did not have any history of hypertension and had normal blood pressure at the baseline developed high blood pressure (i.e., 150/90 mmHg) while on clozapine 100 mg/day. Reduction of the dose of clozapine to 75 mg/day led to the return of blood pressure to baseline, with increase in blood pressure to 150/90 mmHg on increasing the dose of clozapine again, requiring tablet atenolol 50 mg/day for normalization of blood pressure with concomitant continuation of atenolol. Later, clozapine was increased to 350 mg/day, with no recurrence of raise in blood pressure. After 6 months, tablet atenolol was stopped with no evidence of hypertension in follow-up. To conclude, this case report suggests that clozapine can rarely lead to hypertension during the initial phase of treatment.

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“…[ 11 ] However, some of the studies have shown that all the metabolic syndromes in patients receiving clozapine must not be attributed to clozapine, as many patients, in fact, have metabolic syndrome prior to starting of clozapine. [ 12 13 ]…”

Section: Introductionmentioning

confidence: 99%

Metabolic Disturbances, Side Effect Profile and Effectiveness of Clozapine in Adolescents

Grover

Hazari

Chakrabarti

2016

Indian Journal of Psychological Medicine

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Introduction:Data on effect of clozapine on metabolic syndrome in adolescent patients with psychosis are limited. This study aimed to evaluate the prevalence and incidence of metabolic syndrome in children and adolescents with psychotic disorders prior to clozapine and while receiving clozapine. Secondary aims were to study the effectiveness and side effect profile of clozapine.Materials and Methods:Thirteen child and adolescent patients were evaluated at baseline, 3 months, and a follow-up beyond 6 months. Assessments were made for metabolic profile, effectiveness by positive and negative syndrome scale (PANSS), and side effects.Results:Prior to starting of clozapine, the prevalence of metabolic syndrome was 23%. After 3 months on clozapine, 38.5% (5/13) patients fulfilled criteria of metabolic syndrome and further on follow-up beyond 6 months (with last observation carried forward) 46.2% (6/13) had developed metabolic syndrome. There was a significant reduction in PANSS scores at 3 months and follow-up more so in those who developed metabolic syndrome at 3 months. Among the other side effects, hypersalivation was the most common side effect (100%) followed by sedation (69%).Conclusion:Half the prevalence of metabolic syndrome in adolescents on clozapine can be attributed to other factors prior to starting of clozapine, and another half can be attributed to clozapine. Clozapine is effective in an adolescent population.

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An Archival, Follow-Forward Exploration of the Metabolic Syndrome in Randomly Selected, Clozapine-Treated Patients

Cited by 10 publications

References 36 publications

Undiagnosed metabolic syndrome and other adverse effects among clozapine users of Xhosa descent

Undiagnosed metabolic syndrome and other adverse effects among clozapine users of Xhosa descent

Clozapine-induced hypertension: A case report and review of literature

Metabolic Disturbances, Side Effect Profile and Effectiveness of Clozapine in Adolescents

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