클로자핀으로 장기간 치료한 정신분열병 환자의 체중, 혈당, 지질의 변화

Changes of Body Weight, Blood Glucose and Lipid Levels in Patients with Schizophrenia after Long-Term Clozapine Treatment

Objective：This study was designed to investigate the effects of long term clozapine treatment on changes of weight, glucose and cholesterol levels and their relation to clozapine and its metabolite blood levels in outpatients with chronic schizophrenia. Methods：Among outpatients diagnosed with schizophrenia according to the DSMIV criteria, 19 consented subjects receiving long-term treatment of clozapine, its dosage level had been constant for last one month, were selected for the study. The serum level of clozapine, metabolites as well as body weight, BMI, glucose level, cholesterol level, insulin, and c-peptide were gathered and analyzed before and after the use of clozapine. Results：Glucose increase after clozapine treatment was statistically meaningful but it was due to two patients who got diagnosed with diabetes. Glucose levels of other patients are all below 120 mg/dl. Cholesterol level showed significant increase after the treatment. Weight and BMI changes over the treatment are not statistically meaningful overall, but 8 out 17 showed more than 7% increase. The changes of weight and BMI were positively correlated with weight and BMI of pre treatment. Mean serum level of clozapine, metabolites were not correlated with glucose, cholesterol level, insulin, C-peptide. Conclusions：Results indicate that long term treatment of clozapine is correlated with increase of glucose and cholesterol level and weight gain of the patients. Clinicians should be aware of the potential risks of diabetes, hyperlipidemia, and weight gain in patients taking clozapine.