Psychosis and Delirium Following Metabolife Use

Weight gain is a well-known complication of antipsychotic therapy, especially when using newer atypical antipsychotic agents. In addition to the risk of medical comorbidities associated with weight gain, such as diabetes mellitus and cardiovascular disease, a further risk of antipsychotic-induced weight gain is that patients may resort to over-the-counter preparations to aid in weight loss. We report on a case in which a patient with schizophrenia began using Metabolife, an herbal preparation containing ephedra, for weight reduction and subsequently developed an exacerbation of his psychosis with superimposed delirium. We mention several relatively safe alternatives to herbal supplements for weight loss, as well as emphasize the need for clinicians to educate their patients regarding the potential risks of over-the-counter weight loss agents.