Spectrum of binge eating symptomatology in patients treated with clozapine and olanzapine

• Published in: Journal of Neural Transmission Vol. 110; no. 1; pp. 111 - 121
• Main Authors: Theisen, F. M., Linden, A., König, I. R., Martin, M., Remschmidt, H., Hebebrand, J.
• Format: Journal Article
• Language: English
• Published: Wien Springer 01.01.2003; New York, NY Springer Nature B.V
• Subjects: Adolescent; Adult; Antipsychotic Agents - adverse effects; Benzodiazepines; Binge eating; Biological and medical sciences; Body Mass Index; Bulimia - chemically induced; Clozapine - adverse effects; Female; Humans; Hyperphagia - chemically induced; Male; Medical sciences; Neuropharmacology; olanzapine; Pharmacology. Drug treatments; Pirenzepine - adverse effects; Pirenzepine - analogs & derivatives; Psycholeptics: tranquillizer, neuroleptic; Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Risk Factors; Surveys and Questionnaires; Weight Gain - drug effects; Human; side effect; Olanzapine; Neuroleptic; body mass index (BMI); Clozapine; Weight gain; Body mass index; Antipsychotics; Binge eating; Questionnaire on Eating and Weight Patterns (QEWP); bulimia nervosa (BN); neuroleptics; Antipsychotic; binge eating disorder (BED)
• ISSN: 0300-9564; 1435-1463
• DOI: 10.1007/s00702-002-0792-6

The authors explored the binge eating symptomatology in 74 patients receiving clozapine (N = 57) or olanzapine (N = 17), and compared body mass index (BMI, kg/m(2)) and weight gain in patients with and without binge eating symptomatology. Subjects who screened positively for binge eating were interviewed using a modified version of the Questionnaire on Eating and Weight Patterns (QEWP). Current BMIs were assessed cross-sectionally, BMIs at initiation of clozapine/olanzapine treatment retrospectively. Thirty-seven subjects (50%) screened positively. Taking clozapine and olanzapine together, 6/27 (22.2%) females and 3/47 (6.4%) males fulfilled criteria for binge eating disorder, 3/27 (11.1%) females and 2/47 (4.3%) males for bulimia nervosa. Patients who screened positively showed higher current BMIs (26.8 +/- 3.9 vs. 24.7 +/- 3.7 kg/m(2)) and higher BMI increments during clozapine/olanzapine treatment (3.9 +/- 3.1 vs. 2.6 +/- 3.4 kg/m(2)) than patients who screened negatively. We conclude that clozapine/olanzapine may induce binge eating and full blown eating disorders which may have predictive value for weight gain. For future research in this field we suggest a novel DSM-IV research classification "Medication-induced eating disorders".