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Dramatic weight loss associated with commencing clozapine.

John Lally¹, Colm McDonald

¹Department of Psychiatry, National University of Ireland Galway (NUIG), Galway, Ireland. john.lally@nuigalway.ie

BMJ Case Reports

|June 8, 2012

Summary

This case study highlights a schizophrenia patient who experienced significant weight loss while on clozapine, an antipsychotic typically causing weight gain. This unexpected outcome demonstrates potential for weight management alongside symptom improvement.

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Area of Science:

Psychiatry
Pharmacology
Metabolic Disorders

Background:

Schizophrenia is a chronic mental disorder often requiring long-term antipsychotic treatment.
Clozapine is a highly effective antipsychotic for treatment-resistant schizophrenia.
Clozapine is characteristically associated with significant weight gain and metabolic side effects.

Observation:

A 44-year-old male with chronic schizophrenia presented with obesity (BMI 41.5 kg/m²).
The patient initiated clozapine therapy for his psychotic symptoms.
Concurrently, he adopted a modified diet and exercise regimen.

Findings:

Despite clozapine treatment, the patient experienced a dramatic 40% reduction in body weight.
Psychotic symptoms showed marked improvement.
His BMI normalized to 24.8 kg/m².

Implications:

This case challenges the universal expectation of clozapine-induced weight gain.
It suggests that significant weight loss is achievable even with clozapine therapy through lifestyle interventions.
Further research is warranted to explore the mechanisms and potential for similar outcomes in other patients.