Undiagnosed metabolic syndrome and other adverse effects among clozapine users of Xhosa descent
Date
2014-07
Journal Title
Journal ISSN
Volume Title
Publisher
AOSIS Publishing
Abstract
Background. Clozapine use is known to be associated with significant side-effects, including prolongation of the QT-interval, agranulocytosis
and metabolic syndrome. However, few data exist on the prevalence of clozapine side-effects in patients of Xhosa descent.
Objective. To gather data from Xhosa patients with schizophrenia to establish the prevalence of clozapine side-effects in this population.
Methods. Twenty-nine Xhosa patients with schizophrenia (as per the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR))
who had been receiving clozapine treatment for >1 year on an outpatient basis were selected for inclusion. All patients were participating
in a genetics study in the Cape Metropolitan area. The participants were evaluated for the presence of side-effects (tests including an
electrocardiogram, white blood cell count (WCC) and fasting blood glucose).
Results. The prevalence of metabolic syndrome was 44.8% (95% confidence interval (CI) 26.7 - 62.9) and of undiagnosed diabetes mellitus
13.8% (95% CI 1.24 - 26.34). There was a significant association between metabolic syndrome and body mass index (BMI) (p<0.01). The mean
(SD) WCC was 7.8 × 109/L (2.8), with 3.4% of the subjects having a WCC <3.5 × 109/L. Sedation (82.8%; 95% CI 69.0 - 96.5), hypersalivation
(79.3%; 95% CI 64.6 - 94.1) and constipation (44.8%; 95% CI 26.7 - 62.9) were common. The mean QT-interval was 373.8 (35.9) ms and 10%
had a corrected QT-interval >440 ms. There was an association between the duration of clozapine treatment and QT-interval (with Bazett’s
correction).
Conclusion. The high prevalence of metabolic syndrome and undiagnosed diabetes mellitus in this sample points to a need to monitor
glucose levels and BMI on a regular basis. A larger study should be done to accurately quantify the differences in prevalence of side-effects
between population groups.
Description
CITATION: Faasen, N., Niehaus, D.J. ., Koen, L. & Jordaan, E. 2014. Undiagnosed metabolic syndrome and other adverse effects among clozapine users of Xhosa descent. South African Journal of Psychiatry, 20(2):54-57, doi:10.7196/SAJP.528.
The original publication is available at http://www.sajp.org.za
The original publication is available at http://www.sajp.org.za
Keywords
Schizophrenia --Treatment -- Complications, Metabolic syndrome, Clozapine -- Side effects, Xhosa (African people)
Citation
Faasen, N., Niehaus, D.J.H., Koen, L. & Jordaan, E. 2014. Undiagnosed metabolic syndrome and other adverse effects among clozapine users of Xhosa descent. South African Journal of Psychiatry, 20(2):54-57, doi:10.7196/SAJP.528.