title: Excessive weight gain after remission of depression in a schizophrenic patient treated with risperidone: case report.
abstract: 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.
authors.affiliation: Department of Psychiatry, Athens University Medical School, Eginition Hospital, Athens, Greece. theleritis@in.gr
authors.forename: Christos G
authors.initials: CG
authors.lastname: Theleritis
authors.forename: George N
authors.initials: GN
authors.lastname: Papadimitriou
authors.forename: Charalabos C
authors.initials: CC
authors.lastname: Papageorgiou
authors.forename: Dimitris G
authors.initials: DG
authors.lastname: Dikeos
authors.forename: Vasilis
authors.initials: V
authors.lastname: Masdrakis
authors.forename: Constantin
authors.initials: C
authors.lastname: Kostoulas
authors.forename: Constantin
authors.initials: C
authors.lastname: Psarros
authors.forename: Constantin R
authors.initials: CR
authors.lastname: Soldatos
mesh_terms: 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*
chemical_list: D018687:Antidepressive Agents, Second-Generation; D014150:Antipsychotic Agents; D005473:Fluoxetine; D018967:Risperidone