Objective: Obesity is one of the crucial risk factor for cardiometabolic syndrome in general population as well as in schizophrenicpatients. Zonisamide was known for its weight reducing effect in the treatment of epileptic patients and some bipolar patients.The aim of this study was to investigate the weight reducing effect of zonisamide in combination with weight managementprogram designed for schizophrenic inpatients.

Method: One hundred twenty obese schizophrenic inpatients (BMI>27) were randomly assigned to 4 groups: A, controlgroup (N=19), B, zonisamide alone group (N=34), C, weight reduction program alone group (N=32), and D, combination ofzonisamide and weight reduction group (N=35). Daily dose of zonisamide was 100mg/day. Weight-related variables, laboratorytests and side effects were assessed by monthly intervals for 3 months.

Results: Dropouts were 41 patients during 3 months of trial (group A=7 (41.2%), group B=10 (29.4%), group C=17 (53.1%) andgroup D=7 (20%)). Weight loss was significant in group B, C, D from baseline after 2 month of trial. BMI was also significantlydecreased in group B, C and D. Waist circumferences were significantly decreased in group C and D. Blood pressure and bloodglucose was not changed after 3 months of trial. Blood triglyceride was significantly decreased in group B, C and D. HDLcholesterolwas significantly increased in group B and D. Rash was occurred in 3 patients of zonisamide trial groups (4.3%).Other serious adverse events were not found.

Conclusion: Although the combination of zonisamide and weight reduction program was not superior to drug alone or weightreduction treatment alone, our result showed that zonisamide seems to be safe and effective for weight reducing in obeseschizophrenic inpatients.