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

Summary. 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/m²) 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/m²) and higher BMI increments during clozapine/olanzapine treatment (3.9 ± 3.1 vs. 2.6 ± 3.4 kg/m²) 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”. Received February 5, 2002; accepted July 2, 2002 Published online December 9, 2002 Acknowledgements F. Theisen was a recipient of a “Deutsche Forschungsgemeinschaft” (DFG) research fellowship (Th 707/1-1). This study was supported by the DFG (Re 471/11-2) and the “Bundesministerium für Bildung und Forschung” (BMBF). The authors thank the patients who participated in the investigation and the staff of the Psychiatric Rehabilitation Center “Leppermühle” for their assistance. Authors' address: F. M. Theisen, M. D., Clinical Research Group, Department of Child and Adolescent Psychiatry, University of Marburg, Hans-Sachs-Strasse 6, D – 35033 Marburg, Federal Republic of Germany, e-mail: frank.theisen@med.uni-marburg.de