Clozapine induced severe weight loss in resistant schizophrenia managed with risperidone add-on therapy

M Chandradasa,K A L A Kuruppuarachchi,C S Kuruppuarachchi,L C Rathnayake

doi:10.4038/sljpsyc.v11i2.8259

Abstract

The Sri Lanka Journal of Psychiatry (SLJP) is a peer-reviewed, open access journal published bi annually by the Sri Lanka College of Psychiatrists.The Journal publishes original papers, brief reports including case reports and commentaries relevant to psychiatry and allied sciences. The Sri Lanka Journal of Psychiatry is committed to maintaining and conforming to the editorial and ethical standards recommended by the International Committee of Medical Journal Editors.Cover“Perseverance”. These tenacious fishermen in Mannar continue their livelihood despite numerous difficulties. L. N. P. Samarasinghe, Acting Consultant Psychiatrist, Base Hospital Nikaweratiya, Sri Lanka.

Highlights

Clozapine has a significant propensity to cause weight gain, which is considered to be a serotonergic response and is associated with metabolic syndrome [1]
Risperidone, which is a second-generation antipsychotic, has been safely combined with clozapine in previous case reports with an adverse event profile for clozapine/risperidone treatment similar to that for clozapine/placebo [4]
The second person is a male in his early forties diagnosed to have resistant schizophrenia, who was on treatment with clozapine 300 mg daily

Summary

Background

Clozapine has a significant propensity to cause weight gain, which is considered to be a serotonergic response and is associated with metabolic syndrome [1]. The first patient is a female in her late twenties diagnosed with resistant schizophrenia She had been clinically stable for nearly two years on clozapine, with a reduction of positive symptoms. The second person is a male in his early forties diagnosed to have resistant schizophrenia, who was on treatment with clozapine 300 mg daily He had been clinically stable on this dose. It was noticed that he has been losing weight despite having his usual appetite He had lost 10 kgs (17% of his body weight) over six months (from his original weight of 60 kg), and as a result, he became underweight, with a below normal body mass index. He showed a notable response and a further six kilograms over five months, and his weight remained stable at 12 months

Discussion

Findings

Declaration of interests