July 06, 2006

Metabolic Syndrome Risk Increases with Clozapine Use

What is Metabolic Syndrome:

Metabolic syndrome "is a group of conditions that increase the risk for heart disease, stroke and diabetes. The conditions include high blood pressure, excess body fat around the waist, abnormal levels of cholesterol and triglycerides and insulin resistance. Any one of the conditions increases the risk of serious disease. In combination, the risk grows greater."

Clozapine (Clozaril)is one of the most effective antipsychotic drugs used to treat schizophrenia, and physicians are expected to show an increase in prescription rates of the drug because of this. In April, the investigators reported that clozapine was significantly more effective than the new medications. Patients receiving clozapine were less likely to discontinue treatment than those on other drugs. Close monitoring of patients is needed, Rochester researchers say - to prevent and minimize risk of metabolic syndrome for users of Clozaril.

The increased physical health risks must be balanced with the potential benefits of clozapine, the researchers conclude. In addition to its superior efficacy for patients resistant to conventional antipsychotic drugs, clozapine also is the only medication currently approved by the Food and Drug Administration for the treatment of suicidal behavior.

“We need to raise the awareness of physicians about this issue so they monitor their patients and intervene promptly when required to prevent long-term adverse health consequences,” Lamberti said.

“People with schizophrenia are known to exercise less and have poor diets,” Lamberti said. “Those factors contribute to metabolic syndrome. We can’t say how much clozapine contributes to metabolic syndrome, but we have shown the high prevalence of the syndrome in those who take clozapine.”

In the new study by J. Steven Lamberti, M.D, and his team at University of Rochester Medical Center published in the July issue of the American Journal of Psychiatry, concludes that there may be some significant risks associated with clozapine. (This risk is also shared by the other leading atypical antipsychotic medications - so its a general concern that people who take the medications need to be careful of). They examined weight, measured and tested for diabetes, blood lipids, and blood pressure of 93 patients suffering from schizophrenia and being treated with clozapine for 6 months. These patients were compared to a control group of 2,700 participants matched by demographics.

The study found 53.8% of the patients taking clozapine had metabolic syndrome, while only 20.7% of the control did.

The presence of Metabolic Syndrome in these patients would give them a 2 to 3 fold increase in cardiovascular disease mortality.”

One limitation of this study is that it only proves a correlation between metabolic syndrome and clozapine, and not necessarily that one causes the other. Other factors seen in people with schizophrenia, like exercising less and poor diets, may contribute or increase the risk of metabolic syndrome. And further research comparing other drugs used to treat schizophrenia with clozapine will paint a clearer picture of its role in developing metabolic syndrome (read an editorial on this study).

But even without concrete evidence proving cause and effect, the increased risk is there. Lamberti suggests monitoring glucose and blood lipid levels, blood pressure and body weight, for patients taking clozapine.

To Read Complete Press Release

Read Original Article:

Prevalence of the Metabolic Syndrome Among Patients Receiving ClozapineAmerican journal Of Psychiatry(http://ajp.psychiatryonline.org/) July 2006.

Related News:

Clozapine May Impair Glucose Control in Patients with Schizophrenia
Validation of Genetic Biomarker for Determining Risk of Clozapine Induced Agranulocytosis
Doctors Recommendations for Monitoring Health
Incidence of Diabetes Due to Atypical Antipsychotic Medication


suddenly we find lot of research papers which condemn sideffects of CLOZARIL have started appearing in research papers.Is it motivated?Olanzapine,respirodone,quetepine etc have the same sideffects and in fact of more severity.clozaril is the best drug.let research face it

Posted by: captainjohann at July 9, 2006 08:26 AM

I was on Clozapine for around 5 years. At this time I was only awake for around 4 hours a day. I got up to go to the toilet, shower, and eat. I think that Clozapine is a very bad drug. It causes a bad blood condition, and sedation. No wonder I got fat, I was asleep all the time.. I am now on Seroquel, and I have my life back. I am irritated by these studies saying Clozapine is good. When on Clozapine, people don't have a say, as they are too tired to do much to improve their current situations. My friend died on Clozapine. My opinion is that this drug is the most dangerous drug available for treatment of schizophrenia, & should be taken off the market.

Posted by: Peter at July 19, 2006 08:04 PM

I agree its dangerous - I do home inspections - the other day I found an appliance that is being recalled by the manufacturer because 1 in 10,000 seem to be related in causing a fire in a home. Immediatly the appliance had to be unplugged awaiting replacement. The point I am making is that if an appliance is taken off the market due to this minute risk factor, why not so much more so for a drug on humans having serious risk factors.! - They dont even really understand how it works - mere speculation and a shot gun drug approach- no wonder the side effects. -
On a positive side - it seems to also stimulate slow neuron firing in pre-frontal brain areas . this can be achieved more effectively through benign neuro -feedback.

Posted by: jan lombard at February 6, 2007 09:53 PM

I am giving clozapine to my son since 2-3 years. He is 23 yrs old. This is a good medicine and my son has not developed any side effects so far. My doctor has adviced to continue the same


Posted by: mvkulkarni at March 31, 2007 10:28 AM

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