Hormonal correlates of clozapine-induced weight gain in psychotic children: an exploratory study.
OBJECTIVE
Weight gain is a serious side effect of atypical antipsychotics, especially in childhood. In this study, the authors examined six weight gain-related hormones in patients with childhood-onset schizophrenia (COS) after 6 weeks of clozapine treatment.


METHODS
Fasting serum samples for 24 patients with COS and 21 matched healthy controls (HC) were obtained. Levels of leptin, insulin, adiponectin, amylin, ghrelin, and tumor necrosis factor alpha were measured and compared between the groups. For 23 patients with COS, hormonal levels were measured at background and week 6 of clozapine treatment. Change in body mass index was correlated with levels of clozapine and changes in hormonal levels and clinical ratings.


RESULTS
At baseline, COS did not differ significantly from HC on any hormonal measure. Clozapine treatment was associated with significant (7.9% +/- 8.5%) increase in mean body mass index. Only leptin levels increased significantly from baseline to week 6 on clozapine (p = .003). Body mass index increase was significantly correlated with decrease in ghrelin and adiponectin and was positively correlated with clinical improvement.


CONCLUSIONS
This is the first study of weight gain-related hormones in children on clozapine. Hormonal changes are correlated with weight gain. How effectiveness of clozapine is linked to weight gain remains uncertain.
Sporn
Alexandra L
AL
Child Psychiatry Branch, NIMH, NIH, Bethesda, MD, USA. sporna@intra.nimh.nih.gov
Bobb
Aaron J
AJ
Gogtay
Nitin
N
Stevens
Hanna
H
Greenstein
Deanna K
DK
Clasen
Liv S
LS
Tossell
Julia W
JW
Nugent
Thomas
T
Gochman
Peter A
PA
Sharp
Wendy S
WS
Mattai
Anand
A
Lenane
Marge C
MC
Yanovski
Jack A
JA
Rapoport
Judith L
JL
D000293:Adolescent; D014150:Antipsychotic Agents / Q000009:adverse effects*; D015992:Body Mass Index; D002648:Child; D003024:Clozapine / Q000009:adverse effects*; D005260:Female; D006728:Hormones / Q000097:blood; D006801:Humans; D008297:Male; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D015430:Weight Gain / Q000187:drug effects*
D014150:Antipsychotic Agents; D006728:Hormones; D003024:Clozapine