Treatment of weight gain with fluoxetine in olanzapine-treated schizophrenic outpatients

Abstract

Significant weight gain is a side effect associated with olanzapine treatment in some patients. We investigated the efficacy of high-dose fluoxetine as a weight-reducing agent for patients who develop early weight gain with olanzapine treatment. Patients that gained X 3% of their baseline weight in the initial 8 weeks of olanzapine treatment (n = 31) were randomized to double-blind treatment with placebo or fluoxetine (60mg/day). Clinical, weight, and weight-related measures were assessed. Fluoxetine failed to demonstrate weight-reducing effects (fluoxetine group: baseline mean 80.5 kg, SD = 19.1, last mean = 83.5 kg, SD = 19.8; placebo group: baseline mean = 77.1 kg, SD = 12.1, last mean = 78.8kg, SD = 10.6; F =1.3; df = 1,18;p = 0.3). There were no differentialeffects in psychopathology, extrapyramidalside effects or weight-related measures between the placebo and fluoxetine groups. Serotonin reuptake inhibitors are probably not a practicaloption to counteract weight gain induced by atypicalantipsychotics. Atypical-induced weight gain may result from mechanisms otherthan 5HT reuptake blockade. © 2003 Nature Publishing Group.