The aim of this study was to evaluate weight gain during clozapine tre
atment and to determine the possible relationship between psychiatric
improvement and weight gain. 15 treatment-resistant schizophrenic inpa
tients were assessed by rating scales [Brief Psychiatric Rating Scale
(BPRS); Positive and Negative Symptoms Scores (PANSS)] for 21 months.
Bodyweight was evaluated before inclusion and at each subsequent psych
iatric assessment after the beginning of clozapine treatment. In the f
irst period (the period between inclusion and the first minimal value
of BPRS scores), all patients presented with a significant improvement
in total BPRS and other rating scales, reaching at 10 months a 58% de
crease from the initial value of BPRS. However, during the second peri
od (the period after the first minimum), we clearly identified 2 patte
rns of evolution: in group 1, where patients experienced a marked impr
ovement in schizophrenia symptoms followed by subsequent stability, a
regular weight gain was observed; in contrast, no significant weight p
rofile was noted in group 2 where:patients, after an initial response
for 10 months, experienced clinical instability that required higher d
oses of clozapine. These results corroborate the clinically observed c
orrelation between the long term antipsychotic efficacy of clozapine a
nd weight gain.