Safety of Use of Clozapine in Patients With Schizophrenia With Comorbid Diabetes Mellitus.

Abstract

To evaluate the outcome of diabetes mellitus among patients of schizophrenia who had diabetes mellitus before starting clozapine. Clozapine data were screened to detect the patients who had diabetes mellitus before starting clozapine. Those who had diabetes mellitus before starting clozapine were taken up for the study. Of the 468 records screened, 28 patients (5.6%) had diabetes mellitus before starting clozapine. Among the 28 patients, 15 (53.6%) were females, and 13 (46.4%) were male. In three-fourths (75%) of the patients, clozapine was started while these patients were admitted to the inpatient unit. Twenty-six patients had type 2 diabetes mellitus and 2 patients had type 1 diabetes mellitus at the time of starting clozapine. Most patients also had deranged blood glucose levels at the time of starting clozapine and required close monitoring of blood glucose levels and also starting/continuation of antidiabetic medications. None of the patients developed diabetic ketoacidosis during the initial part of the treatment. At the mean follow-up duration of 16 months, most patients were on regular follow-up for more than 1 year, and their blood glucose levels were maintained close to the reference range. Majority of these patients showed good response to clozapine. The present study suggests that presence of diabetes mellitus should not stop the clinicians to use clozapine among patients with schizophrenia. However, close monitoring of blood glucose levels must be done.