Modafinil-associated weight loss in a clozapine-treated schizoaffective disorder patient.
BACKGROUND
We report a case of weight loss associated with modafinil-initiation in a clozapine-treated man with schizoaffective disorder.


METHODS
To report the impact of modafinil, a wake promoting agent that lacks the unwanted side affects brought on by many psychostimulants, on weight in a clozapine-treated patient.


RESULTS
Modafinil was initiated, and over the course of 1 year, Mr. B. experienced a weight loss of 40 lbs (from 280 lbs to 240 lbs) and a reduction in body mass index (BMI) of 5.08 Kg/m2 (from 35.52 Kg/m2 to 30.44 Kg/m2). After 3 years on the combination of clozapine and modafinil, his weight stabilized at 230 lbs (BMI = 29.59 Kg/m2). A 30-lb weight gain over a 6-month period occurred following discontinuation of modafinil. Reinstitution of modafinil resulted in a 10-lb. weight loss over a 6-week period.


CONCLUSIONS
Modafinil treatment resulted in a significant weight loss in this patient, possibly due to reducing clozapine-associated fatigue. Randomized placebo-controlled trials are necessary to evaluate the safety and efficacy of modafinilfor clozapine-associated weight gain.
Henderson
David C
DC
Massachusetts General Hospital Schizophrenia Program, Freedom Trail Clinic, Boston, MA 02114, USA. dchenderson@partners.org
Louie
Pearl M
PM
Koul
Pamposh
P
Namey
Leah
L
Daley
Tara B
TB
Nguyen
Dana D
DD
D000328:Adult; D014150:Antipsychotic Agents; D001559:Benzhydryl Compounds / Q000009:adverse effects* / Q000627:therapeutic use*; D015992:Body Mass Index; D000697:Central Nervous System Stimulants / Q000009:adverse effects* / Q000627:therapeutic use*; D003024:Clozapine; D004347:Drug Interactions; D005221:Fatigue; D006801:Humans; D008297:Male; D000077408:Modafinil; D011618:Psychotic Disorders / Q000188:drug therapy*; D015431:Weight Loss / Q000187:drug effects*
D014150:Antipsychotic Agents; D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D003024:Clozapine; D000077408:Modafinil