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Clozapine
may increase the risk of diabetes
Last Updated: 2005-08-19 14:08:24 -0400 (Reuters Health)
By Michele Rizzo
NEW YORK (Reuters Health) - There appears to be an association
between clozapine treatment and an increased risk of developing
diabetes mellitus, researchers report in the Journal of Clinical
Psychiatry.
"The study suggests that patients receiving clozapine should
be monitored closely for development of diabetes, especially
if they are members of a minority racial or ethnic group,
or if diabetes runs in their families," lead investigator
Dr. J. Steven Lamberti told Reuters Health.
Treatment with antipsychotic drugs has been associated with
an increased risk for developing diabetes mellitus and clozapine
may pose an especially high risk, Lamberti and colleagues
from the University of Rochester Medical Center, New York
note.
To further investigate, they studied 101 outpatients with
schizophrenia or schizoaffective disorder receiving clozapine,
which is sold under the brand name Clozaril. In total, 80
percent were white. The team collected demographic data from
medical records, and conducted body mass index (BMI) and body
fat measurements. A review of medical records and fasting
blood glucose testing was used to establish a diabetes diagnosis.
The prevalence of diabetes was 25.7 percent, and the average
duration of clozapine treatment was 5.7 years. The average
time to diabetes diagnosis following clozapine initiation
was 3.7 years.
The results also revealed significant associations between
diabetes and nonwhite race or ethnicity and family history
of diabetes. The investigators found no association between
diabetes prevalence and BMI or body fat.
Lamberti pointed out that although the mechanism by which
clozapine increases the risk for diabetes is not clear, it
is likely that weight gain is a primary mechanism, "since
clozapine causes more weight gain that any antipsychotic drug,
and weight gain is a well known risk factor for diabetes."
However, he added, other evidence suggests that "clozapine
may cause diabetes by directly affecting pancreatic beta cells,
glucose transport or other mechanisms independent of weight
gain in certain susceptible individuals."
SOURCE: Journal of Clinical Psychiatry, July 2005.
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