title: Improvements in body composition, anthropometric measurements and lipid profile following discontinuation of clozapine.
abstract: BACKGROUND
  Metabolic syndrome (obesity, glucose intolerance, insulin resistance and dyslipidaemia) is a well-known adverse effect of most antipsychotics. It is particularly common in patients treated with olanzapine and clozapine. Currently, the mechanisms underlying its development are not completely understood.
  
  
  METHODS
  We present a case of improved body composition (reduced amount of total body fat and visceral adipose tissue), anthropometric measurements (body weight, waist, abdominal and hip circumferences) and lipid profile in a 31-year-old man with schizophrenia following discontinuation of clozapine. During a combined treatment with clozapine, flupentixol and ziprasidone, a routine laboratory test revealed a severe dyslipidaemia (triglycerides > 1800 mg/dL; > 20.3 mmol/L), despite previous lipid-lowering therapy. This abnormality completely recovered after clozapine has been discontinued.
  
  
  CONCLUSIONS
  Clozapine may cause severe, but reversible metabolic abnormalities, including obesity and hypertriglyceridaemia. Atypical antipsychotic-related lipid abnormalities may have a very rapid onset, occur in relatively young patients, with severe lipid derangements and have potential serious complications. This case confirms how important is to monitor metabolic parameters in patients taking antipsychotics. Discontinuation or switching to another antipsychotic medication may improve components of the metabolic syndrome.
authors.affiliation: a Adam Wysokiński, Department of Old Age Psychiatry and Psychotic Disorders , Medical University of Lodz , Lodz , Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Wysokiński
authors.affiliation: b Tomasz Sobów, Department of Medical Psychology , Medical University of Lodz , Lodz , Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Sobów
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001823:Body Composition / Q000187:drug effects*; D001835:Body Weight / Q000187:drug effects; D003024:Clozapine / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D015228:Hypertriglyceridemia / Q000139:chemically induced*; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced*; D012559:Schizophrenia / Q000188:drug therapy*; D028761:Withholding Treatment
chemical_list: D014150:Antipsychotic Agents; D008055:Lipids; D003024:Clozapine
keywords: Adverse reaction; Body composition; Clozapine; Metabolic syndrome; Obesity; Schizophrenia; Triglycerides