Diabetes as a result of atypical anti-psychotic drugs - a report of three cases

Aims Atypical anti-psychotic drugs (APDs) are widely used in psychotic diso rders refractory to conventional neuroleptic agents. Results Three cases of new-onset diabetes are reported in Caucasian men who were on clozapine (one) or olanzapine (two) for 3-6 months. They had a dis tinct presentation: weight loss, ketosis (one ketoacidosis), severe hypergl ycaemia requiring insulin therapy, and relative insulin deficiency as refle cted by glucagon stimulatory tests. In all cases, insulin was stopped withi n 1 month after the APD was discontinued. Conclusions Novel APDs not only induce diabetes as a result of weight gain in predisposed patients, but can also lead to a reversible state of insulin deficiency, and sometimes ketoacidosis.