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Faasen, N; Niehaus, Dana J H; Koen, L; Jordaan, E

Undiagnosed metabolic syndrome and other adverse effects among clozapine users of Xhosa descent

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  • Media type: E-Article
  • Title: Undiagnosed metabolic syndrome and other adverse effects among clozapine users of Xhosa descent
  • Contributor: Faasen, N; Niehaus, Dana J H; Koen, L; Jordaan, E
  • imprint: AOSIS, 2014
  • Published in: South African Journal of Psychiatry
  • Language: Not determined
  • DOI: 10.4102/sajpsychiatry.v20i2.528
  • ISSN: 2078-6786; 1608-9685
  • Keywords: Psychiatry and Mental health
  • Origination:
  • Footnote:
  • Description: <jats:p>&lt;p&gt;&lt;strong&gt;Background.&lt;/strong&gt; 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. &lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective. &lt;/strong&gt;To gather data from Xhosa patients with schizophrenia to establish the prevalence of clozapine side-effects in this population. &lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods.&lt;/strong&gt; Twenty-nine Xhosa patients with schizophrenia (as per the &lt;em&gt;Diagnostic and Statistical Manual of Mental Disorders&lt;/em&gt; (DSM-IV-TR)) who had been receiving clozapine treatment for &amp;gt;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). &lt;/p&gt;&lt;p&gt;&lt;span&gt;&lt;strong&gt;Results. &lt;/strong&gt;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) (&lt;em&gt;p&lt;/em&gt;&amp;lt;0.01). The mean (SD) WCC was 7.8 × 10&lt;sup&gt;9&lt;/sup&gt;/L (2.8), with 3.4% of the subjects having a WCC &amp;lt;3.5 × 10&lt;sup&gt;9&lt;/sup&gt;/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 &amp;gt;440 ms. There was an association between the duration of clozapine treatment and QT-interval (with Bazett’s correction).  &lt;/span&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion. &lt;/strong&gt;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.&lt;/p&gt;</jats:p>
  • Access State: Open Access