CLOZAPINE AND BODY-MASS CHANGE

Background: Patients treated with clozapine have been reported to gain weight. We hypothesized that patients would also experience an increa se in body mass, which can be more directly related to cardiovascular morbidity. Methods: Forty-two patients who had been treated with cloza pine for at least I gear were weighed and measrtred, and waist-hip rat ios (WHR) and body mass index (BMI), measured as kg/m(2), were calcula ted. Patients were also asked about a series of factors potentially re lated to change in body mass. Results: Female patients gained both wei ght and body mass. Their WHR after 37 months of clozapine therapy was .83, with a significant increase in BMI from 23.2 to 29.1 kg/m(2) (p = .001), Male subjects also gained weight and body mass. Their WHR afte r 39 months of clozapine therapy was .93, with a significant increase in BMI from 26.4 to 29.7 kg/m(2) (p < .001). Stepwise multiple-regress ion analysis showed that factors related to final body mass were initi al body mass, dose of clozapine, and decrease in smoking. Baseline BMI contributed most to the final BMI, but the addition of dose and decre ase in smoking made significant contributions to the model. Conclusion s: Both female and male patients treated with clozapine gain body mass . This may place them at greater risk for cardiovascular morbidity. (C ) 1998 Society of Biological Psychiatry.