Adjuvant Pitolisant in a Case With Early-Onset Schizophrenia.

OBJECTIVES

Early-onset schizophrenia is notorious for poor prognostication and treatment refractoriness. Child/adolescent psychiatric population, by virtue of age, is at a heightened risk for cardiometabolic risk of atypical antipsychotics. Available pharmacological options are, sorely, too limited to mitigate this risk.

METHODS

The authors are reporting here on an adolescent case with early-onset schizophrenia who has favorably responded to olanzapine but with problematic weight gain that failed a trial of add-on metformin. A trial of add-on pitolisant was pursued.

RESULTS

Adjunctive pitolisant has successfully helped with the weight issue. Strikingly, there were parallel improvements in both cognitive and negative domains as well.

CONCLUSIONS

Add-on pitolisant can be a safe and effective strategy to address antipsychotic-induced metabolic syndrome. Gains might also span negative/cognitive domains. This might open new treatment venues for such complicated clinical scenarios that await replication in larger rigorous studies.