Weight gain is a serious problem with recently introduced atypical
antipsychotic agents.
Nizatidine, a histamine2 (H2)-receptor antagonist, may help reduce this
weight gain. To our knowledge, no adverse effects have been reported when
nizatidine is given at recommended doses with atypical antipyschotic agents. We describe, however, an adolescent who was receiving
quetiapine and
paroxetine for
schizophrenia and depression, and developed extrapyramidal symptoms (EPS;
parkinsonism and
akathisia) after taking
nizatidine for
weight loss. Based on a report of another patient who developed EPS after taking higher-than-recommended doses of
nizatidine, we reviewed the literature on treatment with H2-receptor antagonists for
weight gain and on central nervous system adverse effects of
nizatidine.
Nizatidine may be effective for reducing
weight gain associated with both medical and psychiatric conditions. Its safety profile is usually benign, although some patients may develop serious adverse effects, such as EPS and
delirium. Therefore, the
drug is recommended for short-term management of
weight gain associated with atypical
antipsychotic agents. Patients receiving
nizatidine therapy should be monitored closely for development of EPS, particularly when high doses are prescribed.