Weight gain clozapine

Dursun SM, Devarajan S. Clozapine weight gain, plus topiramate weight loss. Can J Psychiatry 2000 45(2) 198. 

Clozapine and olanzapine Increase Unclear weight gain... 

With respect to other ethnic groups, African Americans may have a differential sensitivity to weight gain on clozapine (de Leon etal, 2007). They may also require lower doses than Caucasians (Kelly et al, 2006) and inter-individual as well as ethnic responsiveness maybe partly explained by differences in dopamine receptor polymorphisms (Hwang et al, 2005). It is conceivable that side effects may also be differentially expressed based on pharmacodynamic differences resulting from polymorphisms in other receptor types (histaminergic, muscarinic, etc.). This area remains largely unexplored with respect to ethnic differences in antipsychotic side effects. 

Lu, M. L. et al. (2004). Adjunctive fluvoxamine inhibits clozapine-related weight gain and metabolic disturbances. /. Clin. Psychiatry, 65, 766-71. 

Reynolds, G. P., Zhang, Z. Zhang, X. (2003). Polymorphism of the promoter region of the serotonin 5HT(2C) receptor gene and clozapine induced weight gain. Am. J. Psychiatry, 160, 677-9. 

Leadbetter R, Shutty M, Pavalonis D, Vieweg V, Higgins P, Downs M. Clozapine-induced weight gain prevalence and clinical relevance. Am J Psychiatry 1992 149(1) 68—72. 

Umbricht DS, Pollack S, Kane JM. Clozapine and weight gain. J Clin Psychiatry 1994 55(Suppl B) 157—160. 

Henderson DC, Cagliero E, Gray C, Nasrallah RA, Hayden DL, Schoen-feld DA et al. Clozapine, diabetes melli-tus, weight gain, and lipid abnormalities A five-year naturalistic study. Am J Psychiatry 2000 157(6) 975—981. 

An Example of Major Mental Illness 370 Pharmacodynamics of Clozapine Response 371 Pharmacokinetics of Clozapine Response 372 Tardive Dyskinesia 373 Weight Gain 374... 

Nevertheless, some atypical antipsychotic drugs, such as clozapine and olanzapine, have been linked to substantial weight gain, hyperlipidemia and type II diabetes, a new range of medically serious side-effects. 

Clozapine causes virtually no extrapyramidal side effects and can actually relieve tardive dyskinesia. Nevertheless, it is a difficult medication to tolerate. Its common side effects include drowsiness, weight gain, dizziness, constipation, and drooling (sialorrhea). Clozapine also increases the risk that vulnerable individuals may have seizures. 

Quetiapine (Seroquel). Another atypical antipsychotic, quetiapine has also been approved by the FDA for the treatment of acute mania. It is usually administered twice daily at doses of 150-750mg/day. Like its counterparts, quetiapine is a well-tolerated medication. Its common side effects are drowsiness, dizziness, and headache. It causes less weight gain than olanzapine or clozapine but more than ziprasidone or aripiprazole. Quetiapine also does not cause agranulocytosis nor does it increase the risk of seizures. It can occasionally cause mild changes in liver function tests, but these usually return to normal even if the patient continues taking quetiapine. 

Despite the widespread use of neuroleptics in maintenance treatment of bipolar disorder, there have not been any systematic studies of their suitability for this role. Through clinical experience it has been widely accepted that neuroleptics are useful adjunctive treatments to lithium and related drugs. Treatment refractory patients frequently respond to atypical antipsychotics such as clozapine or risperidone. Such adverse effects as EPS, cognitive dysfunction and weight gain frequently limit the long-term use of classical neuroleptics. For this reason, the atypical neuroleptics such as olanzapine and risperidone should now be considered as alternatives for maintenance treatment. 

HT2 antagonists like trazodone, nefazodone, clozapine and risperidone are used in the treatment of schizophrenia and depression. They block adrenoceptors and Hi-histamine-receptors as well. Hypotension, drowsiness and weight gain can occur. 

All antipsychotics except clozapine and perhaps olanzapine produce hyperprolactinemia by removing the inhibitory actions of dopamine on prolactin secretion. This results in amenorrhea, galactorrhea, and infertility in women and in loss of libido and impotence in men. Inhibition of the release of follicle-stimulating and luteinizing hormones may also play a role. In addition, weight gain is common, and food intake must be monitored. 

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