Past Issues

Background: Antipsychotic drugs such as clozapine are known to potentially
cause metabolic syndrome. In some cases, switching to a different second-generation
antipsychotic drug (SGA) has been reported to resolve the SGA-induced hyperglycemia.
Case Report: We report a case of a 58-year-old woman Taiwanese
patient with long-term schizophrenia who had experienced new-onset, clozapineinduced
type 2 diabetes mellitus during the preceding four months. We changed
clozapine (100-200 mg/day) to ziprasidone (80 mg/day) for seven months, but the
change failed to resolve her hyperglycemia. Subsequently, we switched ziprasidone
to risperidone (4 mg/day) for one month, and she became normoglycemic
(fasting blood glucose level, 92-100 mg/dL). Conclusion: In the case of this patient,
the aggressive switching from one SGA to another one effectively resolved
the antipsychotic drug-induced hyperglycemia. But clinical observations using a
larger number of cases are needed to gain more knowledge in switching among
SGAs.