During our clinical experience with the new neuroleptic drug zotepine we saw some cases of marked weight gain. This retrospective chart review of 110 cases consecutively admitted with the ICD-10 diagnosis of schizophrenia, schizoaffective or delusional disorder (F20-F25) in 1991 and 1992 was aimed at showing whether the weight gain is due to accidental observations or must be considered a side effect of this new drug. The data analysis of all cases treated longer than 2 weeks with a neuroleptic revealed that cases treated with zotepine showed a significant weight gain (3.6 kg) compared to those receiving the "classic" neuroleptics (1.3 kg). A possible link to the pharmacological profile of zotepine (high D2/HT2 affinity with antagonistic effect) is discussed.

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