Implications of Clozapine Complications in Geriatric Patients with Type II Diabetes Mellitus

Abstract

Second-generation antipsychotics, have known metabolic side effects; specifically, clozapine is implicated in worsening or causing hyperglycemia, hypercholesterolemia and weight gain. Recently, there has been an increased interest in the safe use of clozapine in patients with diabetes. In March 2018, a 65-year-old female with a diagnosis of schizophrenia was admitted for inpatient hospitalization to a psychiatric hospital in Buffalo, NY for further stabilization after receiving two months of treatment at a comprehensive psychiatric emergency program (CPEP). Her medical diagnoses included type 2 diabetes mellitus (T2DM), vitamin D deficiency, hyperlipidemia, glaucoma, and constipation. Upon admission, the patient was continued on clozapine, and fluphenazine for treatment of schizophrenia. Her medical medications upon admission included acetaminophen, cholecalciferol, multivitamin, and timolol maleate eye drops. Low blood glucose results at the beginning of her hospitalization led to discontinuation of fingerstick blood glucose readings as the patient was