Hypoglycaemic coma with chlorpropamide.

MILD hypoglycaemic reactions are well recognized as a complication of chlorpropamide therapy, and have been estimated as occurring in 7% of all cases (Stowers & Bewsher, 1962). Severe hypoglycaemic coma due to this drug seems, however, to have been infrequently recognized, and we have been able to find only four isolated reports of this condition in the literature (Coates & Robbins, 1959; Bloch & Lenhardt, 1959; Sackner & Balian, 1960; Lindeman, 1960). We have admitted five patients with severe hypoglycaemic reactions after taking chlorpropamide, one of whom died, during the first 6 months of last year. None of the cases that occurred at home was diagnosed before admission, and all were considered to have suffered some sort of cerebro-vascular accident. Several, indeed, showed abnormal neurological signs. We have had the opportunity to study the four surviving cases to see if there were any reasons for the severe reactions, and if there are any factors that merit special consideration when using this drug.