Adjuvant Pitolisant in a Case With Early-Onset Schizophrenia

Area of Science:

• Child and Adolescent Psychiatry
• Pharmacology
• Metabolic Syndrome

Background:

• Early-onset schizophrenia presents significant challenges in treatment and prognosis.
• Adolescents with schizophrenia are at high risk for cardiometabolic complications from atypical antipsychotics.
• Limited pharmacological options exist to mitigate these risks.

Purpose of the Study:

• To evaluate the efficacy of adjunctive pitolisant in managing olanzapine-induced weight gain in an adolescent with early-onset schizophrenia.
• To assess the impact of pitolisant on cognitive and negative symptoms in this patient population.

Main Methods:

• A case report detailing an adolescent with early-onset schizophrenia who responded to olanzapine but experienced weight gain.
• A trial of add-on metformin was unsuccessful in managing weight gain.
• A subsequent trial of add-on pitolisant was initiated.

Main Results:

• Adjunctive pitolisant successfully resolved the problematic weight gain.
• Significant improvements were observed in both cognitive and negative symptom domains.
• The patient tolerated pitolisant well, indicating a favorable safety profile.

Conclusions:

• Add-on pitolisant represents a safe and effective strategy for managing antipsychotic-induced metabolic syndrome in adolescents.
• Potential benefits extend to improvements in negative and cognitive symptoms.
• Further rigorous studies are warranted to confirm these findings and explore new treatment avenues.