Psychopharmacology Clozapine-associated weight loss: a case report

Clozapine is thought to have the highest risk of cardiometabolic side effects among antipsychotic medications and characteristically associated with weight gain. Despite the clozapine’s tendency to cause weight gain; we reported a patient with substantial weight loss after commencing treatment with clozapine. The patient is a 27-year-old male with a 7-years history of schizophrenia. Over the previous years he had received a number of first and second-generation antipsychotic medications with a partial improvement of symptoms but no remission of his illness. After commencement of clozapine treatment, he experienced a significant weight loss of about 20kg within a period of 6-7 months. There is no evidence to explain the weight loss in physical examination and detailed investigations of the patient, who had no previous diagnosis of a metabolic disease or another medical condition. It is suggested that, clozapine-induced weight loss is often associated with neuroreceptor affinities of the drug, individual genetic variations of receptors, obsessive-compulsive symptoms (compulsive exercise and dieting or obsessionality with food) that may occur because of clozapine and symptomatic and functional improvement provided by treatment.