Clozapine Use in Patients With Schizophrenia and the Risk of Diabetes, Hyperlipidemia, and Hypertension

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Abstract
SINCE 1994, several case reports and uncontrolled studies have linked the atypical antipsychotic clozapine with the development of diabetes mellitus.1-5 Similar reports have been published with the atypical agents olanzapine6,7 and quetiapine fumarate.8 One hypothesis proposes that diabetes may occur secondary to weight gain associated with the atypical antipsychotics.9 Some investigators propose more direct physiological mechanisms, including effects on glucose regulation and insulin secretion and resistance.3,10 Further complicating this relationship is the observation that patients with schizophrenia have a higher rate of diabetes than does the general population.11,12