Hyperglycemia, which is often a prelude to diabetes, is common in patients taking the antipsychotic drug clozapine, according to Michael Sernyak, associate professor of psychiatry at the School of Medicine.
In an article published in the May issue of the Journal of Clinical Psychiatry, Sernyak said 23% of 121 patients who were not previously diagnosed as diabetic and who were taking clozapine had elevated sugar. The patients were at Veterans Administration medical centers throughout New England.
Clozapine is what is known as an atypical antipsychotic drug because it is associated with fewer of the side effects -- such as stiffness, restlessness and symptoms mimicking Parkinson's disease -- than previously offered medications. However, there have been several reports of hyperglycemia and diabetes associated with clozapine use.
"Given this proportion of positive findings, we suggest that patients receiving clozapine should be considered a group at high risk to develop diabetes mellitus and that they deserve both close monitoring and early intervention at the first sign of the onset of either diabetes or impaired glucose tolerance," Sernyak says.
The American Diabetes Association estimates 50% of patients with Type II diabetes are undiagnosed. The outcomes for patients who remain undiagnosed are worse than for patients who are aware of the condition and are taking steps to treat it.
"We expected the ratio to be worse with our patients because they frequently do not receive medical care," Sernyak says.
Co-authors included Dr. Barbara Gulanski, assistant professor of internal medicine in endocrinology; Douglas Leslie, assistant professor of psychiatry and in the Department of Epidemiology and Public Health (EPH), and Dr. Robert Rosenheck, professor of psychiatry and in EPH.
The research was supported by the Department of Veterans Affairs.
-- By Jacqueline Weaver
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