Protracted, dose-dependent weight loss after addition of ziprasidone to a stable regimen of clozapine
✍ Scribed by Jessika Roy-Desruisseaux; Sylvain Grignon
- Book ID
- 102260890
- Publisher
- John Wiley and Sons
- Year
- 2010
- Tongue
- English
- Weight
- 42 KB
- Volume
- 25
- Category
- Article
- ISSN
- 0885-6222
- DOI
- 10.1002/hup.1135
No coin nor oath required. For personal study only.
✦ Synopsis
We have read with great interest the article by Henderson et al. (2009). Although their findings are sobering, we would like to report a case (discussed hereafter) which confirms that some patients can indeed benefit from the addition of ziprasidone to clozapine, and can do so over a protracted time span.
Ms A, a 32-years-old woman diagnosed with schizophrenia and mild mental retardation, was admitted to our unit because of psychotic relapse. At admission, we noted that she had lost 22 kg (48.5 lb) during the preceding year. Her medication consisted of clozapine 600 mg daily and ziprasidone 80 mg am and 100 mg at dinner. A complete medical workup was performed to exclude an underlying medical condition and was normal. The patient was compliant to her medication and has no eating disorder. Clozapine had been stable for over 6 months before ziprasidone was added to the drug regimen as of November 2008. The addition of ziprasidone was associated with a dose dependent, continuous, weight loss during the exposure period (18.5 weeks, mean ziprasidone dose: 65 mg/day, weight loss: 0.15 kg/week; 9.5 weeks, mean ziprasidone dose 154 mg/day, weight loss: 0.42 kg/ week; 25 weeks, mean ziprasidone dose: 180 mg/day, weight loss: 0.63 kg/week). A regression analysis of these data yielded a nearly perfect linear relationship (R 2 ¼ 0.946; F ¼ 17.6) (Figure 1).
The clozapine dosage was stable during the whole period of exposure to ziprasidone and is therefore unlikely to explain the present data. The weight of the patient has remained stable since her admission.
Although building on a single case, this observation suggests that the effect of ziprasidone on weight in the presence of clozapine is dose-dependent and can be significantly delayed (in the present case, two thirds of the weight loss occurred in the last 6 months of exposure).