Olanzapine-Induced Diabetic Ketoacidosis and Neuroleptic Malignant Syndrome with Rhabdomyolysis: A Case Report
Endocrinology and Metabolism
;
: 70-75, 2013.
Article
in English
| WPRIM
| ID: wpr-146598
ABSTRACT
Atypical antipsychotics have replaced conventional antipsychotics in the treatment of schizophrenia because they have less of a propensity to cause undesirable neurologic adverse events including extrapyramidal symptoms, tardive dyskinesia, and neuroleptic malignant syndrome (NMS). However, atypical antipsychotics have been known to result in various metabolic complications such as impaired glucose tolerance, diabetes and even diabetic ketoacidosis (DKA). In addition, a number of NMS cases have been reported in patients treated with atypical antipsychotics, although the absolute incidence of neurologic side effects is currently significantly low. Here, we report a patient who simultaneously developed DKA, acute renal failure and NMS with rhabdomyolysis after olanzapine treatment. Olanzapine-induced metabolic complications and NMS were dramatically improved with cessation of the olanzapine treatment and initiation of supportive management including fluid therapy, hemodialysis, and intensive glycemic control using insulin. At short-term follow-up, insulin secretion was markedly recovered as evidenced by a restoration of serum C-peptide level, and the patient no longer required any hypoglycemic medications. Despite the dramatic increase in the use of atypical antipsychotics treatment, individualized treatments along with careful monitoring may be prudent for high risk or vulnerable patients in order to avoid the development of metabolic side effects.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Rhabdomyolysis
/
Schizophrenia
/
Antipsychotic Agents
/
Benzodiazepines
/
C-Peptide
/
Incidence
/
Follow-Up Studies
/
Renal Dialysis
/
Diabetic Ketoacidosis
/
Acute Kidney Injury
Type of study:
Incidence study
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Endocrinology and Metabolism
Year:
2013
Type:
Article
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