Rapid-onset clozapine-induced loss of glycaemic control: Case report

Alejandro Porras-Segovia, Amir Krivoy*, Mark Horowitz, George Thomas, Mark Bolstridge, Dragos Ion, Sukhwinder S. Shergill

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Clozapine has proved to be an effective antipsychotic for the treatment of refractory schizophrenia - characterised by the persistence of symptoms despite optimal treatment trials with at least two different antipsychotics at adequate dose and duration - but its use is hampered by adverse effects. The development of clozapine-induced diabetes is commonly considered to arise as part of a metabolic syndrome, associated with weight gain, and thus evolves slowly. We present the case of an individual with refractory schizophrenia and metformin-controlled diabetes who developed rapid-onset insulin-dependent hyperglycaemia immediately after starting clozapine. Given the refractory nature of his illness, the decision was made to continue clozapine and manage the diabetes. This case supports the existence of a more direct mechanism by which clozapine alters glycaemic control, aside from the more routine slow development of a metabolic syndrome.

Original languageEnglish
Pages (from-to)138-140
Number of pages3
JournalBJPsych Open
Issue number3
StatePublished - 1 May 2017
Externally publishedYes


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