Excessive weight gain after remission of depression in a schizophrenic patient treated with risperidone: case report.
BACKGROUND
The use of atypical antipsychotics in schizophrenic patients has been associated with a risk of weight gain. Similarly, recovery from depression is often followed by improved appetite, greater food intake and potential increase in weight.


METHODS
A Caucasian 33-year-old schizophrenic female patient was being treated with 6 mg/day of risperidone and 15 mg/day of clorazepate. She developed depressive symptomatology and 40 mg/day of fluoxetine was gradually added to her treatment regimen for about 9 months. After the remission of depression, and the discontinuation of fluoxetine, she experienced an increase in appetite and subsequently excessive weight gain of 52 kg. Re-administration of fluoxetine did not reverse the situation. The patient developed diabetes mellitus, which was successfully controlled with metformin 1700 mg/day. The addition at first of orlistat 360 mg/day and later of topiramate 200 mg/day has helped her to lose a significant part of the weight gained (30 kg).


CONCLUSIONS
The case suggests a probable association between the remission of depressive symptomatology and weight gain in a schizophrenic patient.
Theleritis
Christos G
CG
Department of Psychiatry, Athens University Medical School, Eginition Hospital, Athens, Greece. theleritis@in.gr
Papadimitriou
George N
GN
Papageorgiou
Charalabos C
CC
Dikeos
Dimitris G
DG
Masdrakis
Vasilis
V
Kostoulas
Constantin
C
Psarros
Constantin
C
Soldatos
Constantin R
CR
D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects*; D002032:Bulimia; D003863:Depression / Q000188:drug therapy*; D003920:Diabetes Mellitus / Q000209:etiology*; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D011569:Psychiatric Status Rating Scales; D018967:Risperidone / Q000009:adverse effects*; D012559:Schizophrenia / Q000188:drug therapy*; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects*
D018687:Antidepressive Agents, Second-Generation; D014150:Antipsychotic Agents; D005473:Fluoxetine; D018967:Risperidone