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題名:Remission of Diabetes Mellitus after Switching from Clozapine to Risperidone
書刊名:Taiwanese Journal of Psychiatry
作者:陳宏名黃條來
作者(外文):Chen, Hung-mingHuang, Tiao-lai
出版日期:2012
卷期:26:2
頁次:頁134-137+147
主題關鍵詞:高血糖糖尿病RisperidoneC1ozapineHyperglycemiaDiabetes mellitus
原始連結:連回原系統網址new window
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背景:精神病藥物例如clozapine可能會引發代謝症候群。有報告指出某些併發高血糖的病人在更換另一種抗精神病藥物後,其高血糖得以完全緩解。個案報告:我們報告一位58歲女性患有多年精神分裂症病人,合併有為期四個月clozapine新引發的第二型糖尿病。我們把clozapine更換為ziprasidone歷時七個月後,高血糖仍持續存在。之後再更換zlprasidone為risperidone歷時一個月,最後高血糖獲得完全緩解。結論:在本病例中,積極更換抗精神病藥物有效解除了原本的第二代抗精神病藥物所造成的高血糖。然而這樣的療效,需要臨床更多的有系統的案例研究。
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, clozapine induced 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 nonmoglycemic (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.
期刊論文
1.North American Association for the Study of Obesity、American Diabetes Association、American Association of Clinical Endocrinologists、American Psychiatric Association(2004)。Consensus Development Conference on Antipsychotic Drugs and Obesity and Diabetes。The Journal of Clinical Psychiatry,65(2),267-272。  new window
2.Bergman RN、Ader M(2005)。Atypical antipsychotics and glucose homeostasis。J Clin Psychiatry,66,504-514。  new window
3.Faulkner G、Cohn TA(2006)。Pharmacologic and nonphar-macologic strategies for weight gain and metabolic disturbance in patients treated with antipsychotic medications。Can J Psychiatry,51,502-511。  new window
4.Koller, E.、Schneider, B.、Bennett, K.、Dubitsky, G.(2001)。Clozapine-associated diabetes。Am J Med,111,716-723。  new window
5.Meyer JM、Pandina G、Bossie CA、Turkoz I、Greenspan A(2005)。Effects of switching from olanzapine to risperidone on the prevalence of the metabolic syndrome in overweight or obese patients with schizophrenia or schizoaffective disorder: analysis of a multicenter, rater-blinded, open-label study。Clin Ther,27,1930-1941。  new window
6.Spivak B、Alay SS、Jarskog LF、Sheitman BB、Lieberman JA(2002)。Ziprasidone alternative for olanzapine-induced hyperglycemia。Am J Psychiatry,159,1606。  new window
7.Wu PL、Lane HY、Su KP(2006)。Risperidone alternative for a schizophrenic patient with olanzapine-exacerbated diabetic mellitus。Psychiatry Clin Neurosci,60,115-116。  new window
8.Gaston RL、George M、Azhahan N(2008)。Diabetic control and atypical antipsychotics: a case report。J Med Case Reports,2,155。  new window
9.Starrenburg FC、Bogers JP(2009)。How can antipsychotics cause diabetes mellitus? insights based on receptor-binding profiles, humoral factors and transporter proteins。Eur Psychiatry,24,164-170。  new window
 
 
 
 
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