Primary Outcome Measures:
- change in weight from baseline to endpoint [ Time Frame: 16 weeks ] [ Designated as safety issue: No ]
Secondary Outcome Measures:
- changes, from baseline to endpoint, in BMI [ Time Frame: 16 weeks ] [ Designated as safety issue: No ]
- changes, from baseline to endpoint, in abdominal circumference [ Time Frame: 16 weeks ] [ Designated as safety issue: No ]
- changes, from baseline to endpoint, in metabolic parameters [ Time Frame: 16 weeks ] [ Designated as safety issue: Yes ]
- changes, from baseline to endpoint, in clinical global improvement of psychiatric symptoms [ Time Frame: 16 weeks ] [ Designated as safety issue: Yes ]
- changes, from baseline to endpoint, in manic symptoms [ Time Frame: 16 weeks ] [ Designated as safety issue: Yes ]
- changes, from baseline to endpoint, in depressive symptoms [ Time Frame: 16 weeks ] [ Designated as safety issue: Yes ]
- changes, from baseline to endpoint, in psychotic symptoms [ Time Frame: 16 weeks ] [ Designated as safety issue: Yes ]
This is a single center, 16-week, randomized, double-blind, placebo-controlled, parallel group, flexible-dose study in 60 outpatients with schizophrenia, schizoaffective disorder, schizophreniform disorder, delusional disorder, psychotic disorder NOS, or bipolar disorder types I, II, or NOS by DSM-IV-TR criteria43 with a BMI > 22 for whom treatment with olanzapine (5-20 mg/day) would be appropriate as monotherapy or adjunctive therapy. Subjects who meet entry criteria will be randomized to treatment with olanzapine plus zonisamide or olanzapine plus placebo. All subjects will receive Personal Wellness Solution Counseling (http://www.zyprexa.com/hcp/hcp_patient_c_solutions_print.jsp). Both before and after randomization to zonisamide or placebo, patients will not be permitted to have any other major psychotropic medications (antipsychotics, mood stabilizers, antidepressants, or anxiolytics) added to their medication regimens. The primary outcome measure will be change in weight. Secondary outcome measures will include the Young Mania Rating Scale (YMRS),44 the Inventory for Depressive Symptoms (IDS),45 the Positive and Negative Symptoms Scale (PANSS),46 the Clinician Global Improvement (CGI) scale,47 the Binge Eating Scale (BES) 48, BMI, waist circumference, and metabolic variables (fasting lipids, glucose, insulin).
Subjects will be inpatients or outpatients at the time of randomization to olanzapine-zonisamide or olanzapine-placebo. Throughout the study, psychiatric scales will be used to assess psychiatric symptoms, and the presence of treatment-emergent adverse events will be monitored and recorded.