Journal Title:  Annals of Clinical Psychiatry | Vol:  17 | Issue:  2 | Year:  2005   
Print ISSN:  1040-1237 | Online ISSN:  1547-3325   

Modafinil-Associated Weight Loss in a Clozapine-Treated Schizoaffective Disorder Patient

David C. Henderson MD
Pearl M. Louie MD
Pamposh Koul BS
Leah Namey BS
Tara B. Daley MPH
Dana D. Nguyen PhD

pages: 95 - 97
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Abstract:

Background . We report a case of weight loss associated with modafinil-initiation in a clozapine-treated man with schizoaffective disorder.

Methods . To report the impact of modafinil, a wake promoting agent that lacks the unwanted side affects brought on by many psychostimulants, on weight in a clozapine-treated patient.

Results . Modafinil was initiated, and over the course of 1 year, Mr. B. experienced a weight loss of 40 lbs (from 280 lbs to 240 lbs) and a reduction in body mass index (BMI) of 5.08 Kg/m 2 (from 35.52 Kg/m 2 to 30.44 Kg/m 2 ). After 3 years on the combination of clozapine and modafinil, his weight stabilized at 230 lbs (BMI = 29.59 Kg/m 2 ). A 30-lb weight gain over a 6-month period occurred following discontinuation of modafinil. Reinstitution of modafinil resulted in a 10-lb. weight loss over a 6-week period.

Conclusions . Modafinil treatment resulted in a significant weight loss in this patient, possibly due to reducing clozapine-associated fatigue. Randomized placebo-controlled trials are necessary to evaluate the safety and efficacy of modafinil for clozapine-associated weight gain.