We investigated serum ghrelin levels (SGL) in 12 patients with schizophrenia over a 10-week period after initiation of clozapine treatment. In contrast to increments of body mass indices (BMI, kg/m2) and serum leptin levels (SLL), no significant change in SGL was detected. Inverse correlations between delta SGL and delta SLL did not reach statistical significance. Linear mixed model analysis could not detect effects of age, sex, BMI, SLL and serum clozapine levels on SGL. Our results do not support a causal involvement of ghrelin in clozapine-related weight gain.
Keywords: Leptin, weight gain, body mass index, antipsychotics, neuroleptics.
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Allison, DB, Mentore, JL, Heo, M, Chandler, LP, Cappelleri, JC, Infante, MC, Weiden, PJ 1999Antipsychotic-induced weight gain: a comprehensive research synthesis.Am J Psychiatry15616861696PubMedGoogle Scholar
Atmaca, M, Kuloglu, M, Tezcan, E, Ustundag, B 2003Serum leptin and triglyceride levels in patients on treatment with atypical antipsychotics.J Clin Psychiatry64598604PubMedGoogle Scholar
Baptista, T, Lacruz, A, de Mendoza, S, Mendoza Guillen, JM, Silvera, R, Angeles, F, Mendoza, MT, Hernandez, L 2000Body weight gain after administration of antipsychotic drugs: correlation with leptin, insulin and reproductive hormones.Pharmacopsychiatry338188CrossRefPubMedGoogle Scholar
Brömel, T, Blum, WF, Ziegler, A, Schulz, E, Bender, M, Fleischhaker, C, Remschmidt, H, Krieg, JC, Hebebrand, J 1998Serum leptin levels increase rapidly after initiation of clozapine therapy.Mol Psychiatry37680CrossRefPubMedGoogle Scholar
Brown H, Prescott R (1999) Applied mixed models in medicine. John Wiley & Sons, Chichester New York Weinheim Brisbane Singapore TorontoGoogle Scholar
Gothelf, D, Falk, B, Singer, P, Kairi, M, Phillip, M, Zigel, L, Poraz, I, Frishman, S, Constantini, N, Zalsman, G, Weizman, A, Apter, A 2002Weight gain associated with increased food intake and low habitual activity levels in male adolescent schizophrenic inpatients treated with olanzapine.Am J Psychiatry15910551057CrossRefPubMedGoogle Scholar
Kraus, T, Haack, M, Schuld, A, Hinze-Selch, D, Kuhn, M, Uhr, M, Pollmächer, T 1999Body weight and leptin plasma levels during treatment with antipsychotic drugs.Am J Psychiatry156312314PubMedGoogle Scholar
Leadbetter, R, Shutty, M, Pavalonis, D, Vieweg, V, Higgins, P, Downs, M 1992Clozapine-induced weight gain: prevalence and clinical relevance.Am J Psychiatry1496872PubMedGoogle Scholar
Nakazato, M, Murakami, N, Date, Y, Kojima, M, Matsuo, H, Kangawa, K, Matsukura, S 2001A role for ghrelin in the central regulation of feeding.Nature409194198CrossRefPubMedGoogle Scholar
Otto, B, Cuntz, U, Fruehauf, E, Wawarta, R, Folwaczny, C, Riepl, RL, Heiman, ML, Lehnert, P, Fichter, M, Tschöp, M 2001Weight gain decreases elevated plasma ghrelin concentrations of patients with anorexia nervosa.Eur J Endocrinol145669673CrossRefGoogle Scholar
Schulz, E, Fleischhaker, C, Remschmidt, H 1995Determination of clozapine and its major metabolites in serum samples of adolescent schizophrenic patients by high-performance liquid chromatography – data from a prospective clinical trial.Pharmacopsychiatry282025PubMedGoogle Scholar
Theisen, FM, Cichon, S, Linden, A, Martin, M, Remschmidt, H, Hebebrand, J 2001Clozapine and weight gain.Am J Psychiatry158816CrossRefGoogle Scholar
Theisen, FM, Linden, A, König, IR, Martin, M, Remschmidt, H, Hebebrand, J 2003Spectrum of binge eating symptomatology in patients treated with clozapine and olanzapine.J Neural Transm110111121PubMedGoogle Scholar
Togo, T, Hasegawa, K, Miura, S, Hosojima, H, Kojima, K, Shoji, M, Kase, A, Uchikado, H, Iseki, E, Kosaka, K 2004Serum ghrelin concentrations in patients receiving olanzapine or risperidone.Psychopharmacology172230232CrossRefPubMedGoogle Scholar
Tschöp, M, Smiley, DL, Heiman, ML 2000Ghrelin induces adiposity in rodents.Nature407908913Google Scholar
Tschöp, M, Weyer, C, Tataranni, AP, Devanarayan, V, Ravussin, E, Heiman, ML 2001Circulating ghrelin levels are decreased in human obesity.Diabetes50707709PubMedGoogle Scholar