Author(s)

Amel Kamal Mohammed¹, Ghaday Saad Almutairi², Abdulsalam Abdullah Almreef²

¹Psychiatry Department, Mental Health Hospital, Hafr al-Batin, Saudi Arabia.
²College of Medicine, Qassim University, Unizah, Saudi Arabia.

Clozapine is widely recognized as an effective antipsychotic medication for treatment-resistant schizophrenia, but it is typically associated with significant weight gain. This case report presents two unusual cases of patients with schizophrenia who experienced substantial weight loss while on long-term clozapine therapy. The first case involves a 35-year-old male who lost 21.3% of his initial body weight, and the second case describes a 54-year-old female who lost 30.2% of her initial weight, despite having comorbid hypothyroidism. Both patients showed improvement in psychiatric symptoms concurrent with the weight loss. Comprehensive investigations did not reveal other clear etiologies for the weight reduction. These cases challenge the conventional understanding of clozapine’s metabolic effects and highlight the potential for atypical responses in some individuals. The report discusses possible mechanisms for this unusual phenomenon, including genetic factors and altered pharmacokinetics. It also emphasizes the need for individualized monitoring and management strategies in clozapine therapy. These findings contribute to the growing body of evidence suggesting that metabolic responses to clozapine may be more complex and varied than previously thought, underscoring the importance of personalized approaches in schizophrenia treatment.

Schizophrenia, Clozapine, Weight Loss, Treatment-Resistant, Atypical Antipsychotics, Metabolic Effects, Case Report

Mohammed, A. , Almutairi, G. and Almreef, A. (2024) Atypical Weight Loss in Two Patients with Schizophrenia Treated with Clozapine: A Case Report. Open Journal of Applied Sciences, 14, 2544-2558. doi: 10.4236/ojapps.2024.149168.