Reversal of olanzapine-induced weight gain in a patient with schizophrenia by switching to asenapine: a case report

Abstract

AimsAntipsychotics are effective for treating schizophrenia, but atypical antipsychotics can cause several adverse side effects including weight gain, hyperprolactinemia, and extrapyramidal symptoms. Moreover, weight gain increases the risk of metabolic diseases.MethodsWe treated a case of olanzapine-induced weight gain in a 41-year-old man with schizophrenia by switching his medication from olanzapine to asenapine.ResultsThe weight gain improved after switching the medication, from 80.3 to 75.0 kg, a weight loss of 6.6%, and there was no significant worsening of psychological symptoms or other adverse effects.ConclusionsAsenapine might be effective for treating patients with schizophrenia who experience olanzapine-induced weight gain.

Clinical and Biological Perspectives of Non-antipsychotic Psychotropic Medications and Weight Gain

“…Evidence suggest that not all psychotropic drugs lead to weightgain: SSRIs (fluoxetine, appetite suppression and initial titration with low doses) causes weight loss during the first few weeks of use [31]; antiepileptic felbamate causes weight loss in about 75% of patients with intractable epilepsy [32]; and topiramate [33] tend to cause weight loss. Asenapine an antipsychotic and mood stabilizer has mixed results regarding weight gain (negligible to 0.9 kg; 19% vs. 31% [with olanzapine]) in patients with bipolar disorder I and schizophrenia and weight loss in 6.6% of patient treated with olanzapine during initial phase of treatment [34][35][36]. Like carbamazepine and valproate, oxcarbamazepine tend to cause significant weight gain in about 15.4% of children [37].…”