Diabetes Mellitus Among Outpatients Receiving Clozapine

Lamberti, J. Steven; Costea, G. Oana; Olson, David P.; Crilly, John; Maharaj, Kumar; Tu, Xin; Groman, Adrienne; Dietz, Marci B.; Bushey, Margaret P.; Olivares, Telva; Wiener, Karen

doi:10.4088/jcp.v66n0713

Cited by 37 publications

(5 citation statements)

References 46 publications

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“…Clozapine dose also seems to affect the occurrence of MetS, as was found by Josiassen et al (84) and Brunero et al 2009 (86). Finally, the duration of clozapine treatment was found to be associated with MetS in two studies (22,84).…”

Section: Clozapinementioning

confidence: 96%

“…The use of concomitant mood stabilizers was reported to be a risk factor for MetS in two studies (81,85,94) Higher baseline BMI was reported to be associated with MetS in two studies (84,94). In four other studies, it was shown that higher current BMI is also a risk factor for MetS in patients treated with clozapine (22,78,86,92). Clozapine dose also seems to affect the occurrence of MetS, as was found by Josiassen et al (84) and Brunero et al 2009 (86).…”

Section: Clozapinementioning

confidence: 96%

“…Evidence for weight gain was found for clozapine, zotepine, olanzapine, and sertindole, iloperidone, quetiapine, risperidone and paliperidone, and brexpiprazole. SGA are also associated with glucose abnormalities and development of DM2 (9,(20)(21)(22)(23). Pillinger et al (24), performed a large metaanalysis to compare and rank antipsychotics based on their metabolic side-effects and to identify predictors of antipsychoticinduced metabolic dysregulation.…”

Section: Introductionmentioning

confidence: 99%

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Clinical, Biochemical and Genetic Variables Associated With Metabolic Syndrome in Patients With Schizophrenia Spectrum Disorders Using Second-Generation Antipsychotics: A Systematic Review

et al. 2021

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Background: Individuals with severe mental illness experience increased morbidity and mortality compared to the general population. Adverse effects of antipsychotics, including weight gain, may contribute to the development of metabolic syndrome (MetS), which is associated with increased risks of all-cause and cardiovascular disease mortality. We aim to provide a comprehensive overview of clinical, biochemical and genetic factors associated with MetS among patients with schizophrenia spectrum disorders using second-generation antipsychotics (SGA).Methods: A literature search was performed in Pubmed and Embase to identify all cohort studies, cross-sectional studies and clinical trials investigating associations with MetS in patients with schizophrenia spectrum disorders using SGAs. We extracted and enumerated clinical, biochemical and genetic factors reported to be associated with MetS. We defined factors associated with MetS as factors being reported as associated with MetS in two or more studies.Results: 58 studies were included in this review (n = 12,123). In total, 62 factors were found to be associated with increased risk of MetS. Thirty one out of 58 studies investigated factors that were reported as associated with MetS in two or more studies. With regard to clinical factors, we found gender, higher age, concomitant use of mood stabilizers, higher baseline and current BMI, earlier SGA exposure, higher dose, longer duration of treatment, psychosis and tobacco smoking to be significantly associated with MetS. Furthermore, the biochemical factors hypo-adiponectinemia, elevated levels of C-reactive protein (CRP) and higher white blood cell (WBC) count were identified as factors associated with MetS. Among pharmacogenetic factors, the rs1414334 C-allele of the HTR2C-gene was associated with MetS in patients using SGA.Conclusion: In this systematic review investigating clinical, biochemical and genetic factors associated with MetS in patients using SGAs we found that higher age, higher baseline BMI, higher current BMI and male as well as female gender were positively associated with MetS across all antipsychotics. This study may set the stage for the application of clinical, biochemical and genetic factors to predict the risk of developing MetS in patients using SGAs. Future research is needed to determine which patients using SGAs are at risk to develop MetS in clinical practice.

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Section: Clozapinementioning

confidence: 96%

Section: Clozapinementioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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Clinical, Biochemical and Genetic Variables Associated With Metabolic Syndrome in Patients With Schizophrenia Spectrum Disorders Using Second-Generation Antipsychotics: A Systematic Review

et al. 2021

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“…This result was consistent with previous studies [ 19 , 26 , 27 ]. However, another study failed to find the sex difference in the DM rates in SCZ [ 28 ]. Moreover, one study found more insulin resistance and dyslipidemia in males than in females with first-episode SCZ patients [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Sex differences in the prevalence and clinical correlates of diabetes in Chinese patients with chronic schizophrenia

H¹,

Li²,

Shen³

et al. 2023

Heliyon

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“…Over 10 weeks-the most of any antipsychotic drug. More case reports of clozapine-associated glucose abnormalities have been submitted to the Food and Drug Administration [11] and published [12] than for any other antipsychotic drug (Figure 1). Reports have also associated clozapine treatment with the development of Hypertriglyceridemia [13], Increased total cholesterol levels [14], and Hypertension [15].…”

mentioning

confidence: 99%

"Effect of Clozapine on Appetite, Weight and Insulin Resistance in Schizophrenia Patient in Mental Health Psychiatry Outpatient Clinics KFSH&RC (Case Report)"

2019

COJNH

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Background: Schizophrenia is a psychotic disorder with a complex pathophysiology and requires treatment that includes long term administration of antipsychotics that is said to be associated with metabolic syndrome.Objective: To estimate the prevalence of metabolic syndrome in patients taken clozapine at King Faisal Specialist Hospital &Research Centre, Outpatient clinics.Methods: This study was conducted at outpatient setting, KFSH&RC. Total patients included in this study are 39 patients. All patients were on maintenance dose of clozapine therapy. Measurement of anthropometric (body weight (BMI), waist circumference, blood pressure) and biochemical parameters (glucose, insulin, triglycerides, LDL, HDL) were recorded, Data analyses were collected during their regular follow-ups. Result:The prevalence of the metabolic syndrome was significantly higher among clozapine patients according to all literature but in this study 3 patients out of 39 were affected. The analysis revealed significant associations with age, body mass index, and duration of clozapine medication & family history. This finding is consistent with literature about associated with clozapine& mentioned risk factor. Our three affected patients had the following result.

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Diabetes Mellitus Among Outpatients Receiving Clozapine

Cited by 37 publications

References 46 publications

Clinical, Biochemical and Genetic Variables Associated With Metabolic Syndrome in Patients With Schizophrenia Spectrum Disorders Using Second-Generation Antipsychotics: A Systematic Review

Clinical, Biochemical and Genetic Variables Associated With Metabolic Syndrome in Patients With Schizophrenia Spectrum Disorders Using Second-Generation Antipsychotics: A Systematic Review

Sex differences in the prevalence and clinical correlates of diabetes in Chinese patients with chronic schizophrenia

"Effect of Clozapine on Appetite, Weight and Insulin Resistance in Schizophrenia Patient in Mental Health Psychiatry Outpatient Clinics KFSH&RC (Case Report)"

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