Leptin Concentrations Are Increased in Subjects Treated With Clozapine or Conventional Antipsychotics
J Clin Psychiatry 2001;62(11):843-848
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Overweight is a considerable
clinical problem in patients treated with antipsychotic agents.
Recent results suggest that insulin resistance with increased
insulin levels is also associated with treatment with the
atypical antipsychotic agent clozapine. Leptin is important for
the control of body weight and has been proposed to be
a link between obesity and the insulin resistance syndrome. This
study examined if clozapine-treated subjects and subjects treated
with conventional antipsychotics had increased leptin levels
compared with the general population and whether there was a
gender difference in this respect.
Method: Clozapine-treated patients (N =
41), patients treated with conventional antipsychotic drugs (N =
62), and healthy subjects from the Northern Sweden Monitoring of
Trends and Determinants in Cardiovascular Disease (MONICA)
project (N = 189) were investigated with a cross-sectional study
design. Weight, body mass index (BMI), and plasma leptin
concentrations were measured, and all study subjects were
investigated for the presence of diabetes mellitus. Drug
treatment, health status, and smoking habits were registered.
Results: After adjustment for gender,
BMI, smoking habits, age, and diabetes, hyperleptinemia was
independently (p < .001) associated with clozapine treatment
and with treatment with conventional antipsychotics (p < .005)
within a multiple regression analysis. In separate multiple
regression analyses, leptin levels were significantly associated
with clozapine treatment in men (p = .002) and women (p = .023)
and with conventional antipsychotic treatment in men (p = .027)
but not in women.
Conclusion: Treatment with clozapine as
well as with conventional antipsychotics is associated with
increased levels of circulating leptin. Hyperleptinemia can be an
important link in the development of overweight and the insulin
resistance syndrome in subjects receiving antipsychotic drugs,
especially atypical agents like clozapine.