Quetiapine-Induced Weight Gain and Escitalopram

Amy, a 16-year-old adolescent, was treated with quetiapine for a first psychotic episode over 5 months with an absence of weight gain. Because her depressive symptoms were pronounced after remission of her psychotic symptoms, the introduction of escitalopram was followed by a dramatic increase in weight (8 kg over 1 month). This worrisome side effect led to replacing quetiapine with amisulpride. Quetiapine discontinuation was followed by a transient decrease in weight gain. The reappearance of severe psychotic symptoms with amisulpride treatment led us to reintroduce quetiapine because Amy was previously responsive to this treatment. Unfortunately, a novel dramatic increase in weight was observed, with an additional 8-kg gain over 1 month. Discontinuation of escitalopram and replacement by topiramate was followed by weight stabilization.