Aripiprazole
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Hypoglycaemia in an elderly patient: case report A 72-year-old man developed hypoglycaemia during treatment with oral aripiprazole for psychosis. The man started receiving aripiprazole 10 mg/day and developed nonspecific behavioural changes, weakness, fatigue, palpitation and anxiety 10 days later. His symptoms progressed and 21 days after aripiprazole initiation, he suddenly developed confusion, sweating, palpitation, hunger, paraesthesia and loss of consciousness. He was hospitalised, and examinations revealed pallor, a BP of 146/90mm Hg, a pulse rate of 120/minute, a haemoglobin level of 11.8 g/dL and a random blood glucose level of 46 mg/dL. An ECG showed tachycardia and non-specific Twave flattening in leads V3 and V5. Severe hypoglycaemia was diagnosed. The man received glucose and fluids, and his condition improved. His blood glucose level was 130 mg/dL after resuscitation, and he was discharged 2 days later with a fasting blood glucose level of 111 mg/dL and a 2-hour postprandial blood glucose level of 120 mg/dL. Aripiprazole was discontinued, and his hypoglycaemic symptoms did not recur. Oral aripiprazole was subsequently restarted at a dosage of 5 mg/day, and the man developed hypoglycaemic symptoms after 6 days. On the seventh day, his fasting blood glucose and 2-hour postprandial blood glucose levels were 62 mg/dL and 71 mg/dL, respectively. Aripiprazole was stopped, and his symptoms resolved, along with a normalisation of his glycaemic status. Olanzapine treatment was initiated. Author comment: "Naranjo adverse drug reaction probability scale suggests that there is a ‘definite’ relationship between administration of aripiprazole and onset of hypoglycemic events." Mondal S, et al. Oral aripiprazole-induced severe hypoglycemia. Therapeutic Drug Monitoring 34: 245-248, No. 3, Jun 2012. Available from: URL: http:// 803074306 dx.doi.org/10.1097/FTD.0b013e3182557d10 - India
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Reactions 28 Jul 2012 No. 1412
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