Modafinil-associated weight loss in a
clozapine-treated schizoaffective disorder patient

by
Henderson DC, Louie PM, Koul P, Namey L, Daley TB, Nguyen DD.
Massachusetts General Hospital Schizophrenia Program,
Freedom Trail Clinic, Boston, MA 02114, USA.
dchenderson@partners.org
Ann Clin Psychiatry. 2005 Apr-Jun;17(2):95-7.


ABSTRACT

BACKGROUND: We report a case of weight loss associated with modafinil-initiation in a clozapine-treated man with schizoaffective disorder. METHODS: To report the impact of modafinil, a wake promoting agent that lacks the unwanted side affects brought on by many psychostimulants, on weight in a clozapine-treated patient. RESULTS: Modafinil was initiated, and over the course of 1 year, Mr. B. experienced a weight loss of 40 lbs (from 280 lbs to 240 lbs) and a reduction in body mass index (BMI) of 5.08 Kg/m2 (from 35.52 Kg/m2 to 30.44 Kg/m2). After 3 years on the combination of clozapine and modafinil, his weight stabilized at 230 lbs (BMI = 29.59 Kg/m2). A 30-lb weight gain over a 6-month period occurred following discontinuation of modafinil. Reinstitution of modafinil resulted in a 10-lb. weight loss over a 6-week period. CONCLUSIONS: Modafinil treatment resulted in a significant weight loss in this patient, possibly due to reducing clozapine-associated fatigue. Randomized placebo-controlled trials are necessary to evaluate the safety and efficacy of modafinilfor clozapine-associated weight gain.


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