Diabetes as a result of atypical anti-psychotic drugs--a report of three cases

Diabet Med. 2000 Jun;17(6):484-6. doi: 10.1046/j.1464-5491.2000.00296.x.


Aims: Atypical anti-psychotic drugs (APDs) are widely used in psychotic disorders refractory to conventional neuroleptic agents.

Results: Three cases of new-onset diabetes are reported in Caucasian men who were on clozapine (one) or olanzapine (two) for 3-6 months. They had a distinct presentation: weight loss, ketosis (one ketoacidosis), severe hyperglycaemia requiring insulin therapy, and relative insulin deficiency as reflected by glucagon stimulatory tests. In all cases, insulin was stopped within 1 month after the APD was discontinued.

Conclusions: Novel APDs not only induce diabetes as a result of weight gain in predisposed patients, but can also lead to a reversible state of insulin deficiency, and sometimes ketoacidosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antipsychotic Agents / adverse effects*
  • Benzodiazepines
  • Clozapine / adverse effects
  • Depressive Disorder / drug therapy
  • Diabetes Mellitus / chemically induced*
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / drug therapy
  • Glyburide / therapeutic use
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Male
  • Middle Aged
  • Olanzapine
  • Pirenzepine / adverse effects
  • Pirenzepine / analogs & derivatives*
  • Psychotic Disorders / drug therapy*
  • Schizophrenia / drug therapy


  • Antipsychotic Agents
  • Hypoglycemic Agents
  • Insulin
  • Benzodiazepines
  • Pirenzepine
  • Clozapine
  • Olanzapine
  • Glyburide