Weight increase among schizophrenia patients with clozapine treatment

Running head: EPIDEMIOLOGY
EPIDEMIOLOGY
[Author Name(s), First M. Last, Omit Titles and Degrees]
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EPIDEMIOLOGY
Outcomes of obese Clozapine-treated in-patients with schizophrenia placed on six-month diet
and physical activity program
1) Overview of the paper
The paper addresses a number of issues such as the weight increase among patients with
schizophrenia and who are undergoing clozapine treatment. The weight increase among the
schizophrenia patients is as a result of the enhanced appetite them. Diabetes Mellitus,
cardiovascular disease, and hypertension are the other conditions of obesity among the
schizophrenia patients, these conditions may be of serious detriment to the health of the
patients (ARONSON, 2010).
Clozapine drug is a benzodiazepine derivative and a generation antipsychotic for the
treatment of schizophrenia patients. Clozapine is has been found out to be having a greater
potential to induce weight increase in human beings (Aronson, 2013). Weight gained as a
result of antipsychotics is a main cause of noncompliance which results in a discontinuation
of treatment which in turn causes psychotic symptoms (Barnes, 2013). However metabolic
changes such as reduced levels of insulin, higher levels of cholesterol, triglyceride, and
glucose have been seen to be having a greater impact among long-term clozapine patients as
compared to those who are treated with second-generation antipsychotics (Buckley,
2016).It is of great importance to manage the condition of weight gain among patients who
are undergoing long-term medication of clozapine without implementing alternatives
medications.
The paper is of great importance as it explains the root causes of the unexpected weight
increase among patients who are undergoing treatment with clozapine and what should be
done to avoid the rise of obesity-related conditions to this patient which in turn can result to
overall deteriorating of their health. Hormones of growth are considered to be very powerful

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agents in regulating and maintaining effective functioning of the cardiovascular system, it
improves on how the cardiac system functions this is due to the fact that low levels of this
hormones result in health diseases (DiPiro, 2014).
Exposure or intervention of the study
Many innervations were put in place to avert this, such as the control of the diet which
was implemented and championed by a registered dietician whose main intention was to
ensure that the intake of calories was restricted within 1,300 and 1,500 kcal for women per
day and 1,600 and 1800 kcal for men per day (Fawcett, 2013). The caloric intake was
measured and accessed types of different foods which the patients ate which were including
the vegetables and fruits, foods which were free of sugars, drinks and artificial sweeteners.
The intake of the macronutrients was to ensure that the participants were in compliant
with the expected results (French, 2014). The Taiwanese diet currently is 10% to 14%
calories which are obtained from proteins 20 to 30 percent obtained from fats and 58 to 68
percent from carbohydrates.it was recommended that people of all ages should obtain 30
minutes of physical activities which are of moderate intensity such brisk walking in most
days of the week. The physical activity programme was designed so as to fit the hospital
environment in which the patients will be exercising. To motivate participants were awarded
rewards such as soap, toilet papers, and drinks which are free of sugars (French, 2014).
The study design during the study
Body parameters and other anthropometric measurements were accessed after the
overnight fasting of the participants. A body composition analyzer also measured body
weight and the percentage of fats in the body. Audiometer was used to measure the height of
the participants. Hip and waist circumferences were measured in centimeters. The BMI was

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achieved by calculating weight divided by the height squared. Waist to hip ratio was
calculated dividing the waist circumference with hip circumference (James, 2011).
The effectiveness of the treatment plan was assessed by covariance and variance
analysis. The metabolic, hormonal an anthropometric data which was obtained from the study
which was carried out as compared with the data which was obtained from the control group.
Analysis of the metabolic and enzyme immunoassay, serum, glucose, cholesterol,
triglyceride and pro lactic were measured from blood by using an autoanalyzer which
measures glucose, triglyceride enzyme, and cholesterol respectively. Insulin, serum cortisol,
and prolactin were measured by an enzyme immunoassay system (Jobson, 2017).
Blood sampling was carried out after the overnight fasting whereby blood samples
were drawn from the patients by a trained phlebotomist .from the blood samples which were
drawn were used for the analysis of the metabolic rates and enzyme assay (Jobson, 2017).
The controlled and randomized study which took place was undertaken so as to
investigate and benefits of dietary control and the impacts of physical exercises on the
patients who are suffering from the condition of obesity with patients of schizophrenia who
are undergoing clozapine treatment (Kasper, 2014).
The study population
The participants who took place in the study included the 753 hospitalized patients.in
the years of 2003 and 2004 .all the patients who were diagnosed they had a DSM-iv
schizophrenia and all of them were between the age of 18 and 65 years old. They considered
having the patients taking at least 300mg of the prescribed clozapine orally daily for at least
one year and having a body mass of which is greater than 27kg/m2 (Koslow, 2013).The
people with such mass are considered to be obese.patients who were taking any other
antipsychotic other than clozapine were excluded and if they were taking any other lipid