Diabetic ketoacidosis and prolonged hyperchloraemic acidosis in a patient treated with risperidone

Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes. The development of metabolic syndrome is widely recognised with the use of atypical antipsychotic agents, and not infrequently DKA has been described with some of these drugs. We describe a complex patient with HIV who presented with severe DKA and prolonged hyperchloraemic acidosis, which we postulate was associated with risperidone therapy.