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題名 | 服用氯氮平併發糖尿病:二例報告=Clozapine-associated Diabetes Mellitus:Report of Two Cases |
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作者 | 邱偉哲; 張景瑞; Chiu, Wei-che; Chang, Ching-jui; |
期刊 | 臺灣精神醫學 |
出版日期 | 20010300 |
卷期 | 15:1 2001.03[民90.03] |
頁次 | 頁71-76 |
分類號 | 418.21 |
語文 | chi |
關鍵詞 | 氯氮平; 精神分裂症; 糖尿病; Clozapine; Dibenzepines; Schizophrenia; Diabetes mellitus; |
中文摘要 | 目的:報告二位使用氯氮平後發生糖尿病症之華人個案,所呈現臨床表現與處置 。病例報告:甲先生,34歲之精神分裂症病患,有家族糖尿病史。使用氯氮平治療後,出現 體重下降、食慾增加、口渴等症狀,內科住院診斷為糖尿病,以胰島素注射治療至今。乙先 生,為一46歲肥胖慢性精神分裂症病患,使用氯氮平兩年出現無症狀之高血糖症。結論:氯 氮平誘發高血糖作用機轉目前仍不明確,對於有糖尿病病史與家族史以及肥胖之病患,使用 氯氮平治療,值得密切注意其臨床症狀與血糖。 |
英文摘要 | Objective: Clozapine is an atypical antipsychotic drug used for refractory schizophrenic patients. Several cases of severe hyperglycemia have been reported associated with clozapine use. We report two Taiwanese schizophrenic patients who developed diabetes mellitus after clozapine treatment . Case Report: Mr. A was 34-year-old, non-obese Taiwanese male presenting with schizophrenia and a family history of diabetes mellitus. His own medical history revealed no precursors for diabetes and laboratory studies before clozapine treatment revealed normal serum glucose level. After 18 weeks of clozapine management, treatment was changed to clotiapine because of severe sialorrhea. Six months after discontinuing clozapine, Mr. A developed diabetes with polydipsia, polyuria and weight loss (12 kg/2 weeks). Mr. B was a 46-year- old Taiwanese man with refractory schizophrenia and obesity. His hyperglycemia was discovered incidentally after two years of combined clozapine and fluvoxamine treatment. The patient's psychiatric condition was quite stable and his diabetes under dietary control. Conclusion: Clozapine may hasten the onset of diabetes through both direct and indirect effects. Clozapine should be administered with great care for patients with risk factors which include obesity, weight gain and a personal and family history of diabetes. (Full Text in Chinese) |
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