Clozaphobia: Is avoidance of clozapine in diabetes warranted?

Asian J Psychiatr. 2017 Aug:28:142-145. doi: 10.1016/j.ajp.2017.04.005. Epub 2017 Apr 14.

Abstract

Despite its superior efficacy, clozapine is an underutilized agent, primarily owing to the "Clozaphobia"-fear of clozapine's adverse effects. Emergent cautions on metabolic side-effects have contributed to avoidance of clozapine prescription. Here, we describe our clinical experience with nine patients having schizophrenia/schizoaffective disorders with comorbid diabetes mellitus and treated with clozapine. Interestingly, all patients could be maintained on optimal glycemic control even after clozapine. In conclusion, a critique on the potential risks versus benefits of clozapine amidst our observations from this case series adds further supporting evidence to the emerging literature on the clinical utility of clozapine in treating schizophrenia patients with diabetes mellitus.

Keywords: Clozapine; Diabetes mellitus; Metabolic syndrome; Treatment resistant schizophrenia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antipsychotic Agents / adverse effects*
  • Clozapine / adverse effects*
  • Comorbidity
  • Diabetes Mellitus / blood*
  • Diabetes Mellitus / epidemiology
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Phobic Disorders / psychology
  • Psychotic Disorders / drug therapy*
  • Psychotic Disorders / epidemiology
  • Schizophrenia / drug therapy*
  • Schizophrenia / epidemiology

Substances

  • Antipsychotic Agents
  • Clozapine

Supplementary concepts

  • Phobia, Specific