Anti-psychotic meds and weight gain.
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Slowfaster
Posts: 185 Member
Some people have expressed an interest in this problem, so , without suggesting radical calorie restriction, I thought we should discuss it.
First of all, anti-psychotics should not be confused with anti-depressants like Prozac or Wellbutrin.
Examples of anti-psychotics are Abilify, Zyprexa, Clozapine, and Haldol. They are used, most often, to treat bipolar or schizophrenia.
They all cause significant weight gain. Sixty pounds the first year is common. A recent study by John Hopkins University has connected the weight gain with an increase in the brain of a histamine that causes hunger. It increases to about four times the level in people who don't take anti-psychotics and produces ravenous hunger. This study provides hope that new drugs will be tweaked to provide relief of symptoms without raising the histamine, but that will take time.
In the meantime, all that can be done is to eat nutritious food and exercise. Volumetrics is a good plan for this problem because the excessive hunger is soothed a little by eating large amounts of low calorie foods like salads and soups.
My niece has schizophrenia and gained about sixty pounds since she started on Zyprexa. Her doctor switched her to Abilify, but the weight gain continued. She remains on Abilify and considers this drug a life saver. It's hard for a young girl, formerly as thin as a model, to accept this sort of weight gain, but compared to her pre-medicated state -- virtually trapped inside a nightmare, hearing voices and constantly terrified-- the trade off is well worth it. Now she is at peace, able to work and study and enjoy life again.
If you are on an anti-psychotic and considering going off it to lose wait -- don't. Your sanity and mental balance are far more important than a number on a scale. There are worse things in life than being a beautiful, happy, plus sized young lady.
First of all, anti-psychotics should not be confused with anti-depressants like Prozac or Wellbutrin.
Examples of anti-psychotics are Abilify, Zyprexa, Clozapine, and Haldol. They are used, most often, to treat bipolar or schizophrenia.
They all cause significant weight gain. Sixty pounds the first year is common. A recent study by John Hopkins University has connected the weight gain with an increase in the brain of a histamine that causes hunger. It increases to about four times the level in people who don't take anti-psychotics and produces ravenous hunger. This study provides hope that new drugs will be tweaked to provide relief of symptoms without raising the histamine, but that will take time.
In the meantime, all that can be done is to eat nutritious food and exercise. Volumetrics is a good plan for this problem because the excessive hunger is soothed a little by eating large amounts of low calorie foods like salads and soups.
My niece has schizophrenia and gained about sixty pounds since she started on Zyprexa. Her doctor switched her to Abilify, but the weight gain continued. She remains on Abilify and considers this drug a life saver. It's hard for a young girl, formerly as thin as a model, to accept this sort of weight gain, but compared to her pre-medicated state -- virtually trapped inside a nightmare, hearing voices and constantly terrified-- the trade off is well worth it. Now she is at peace, able to work and study and enjoy life again.
If you are on an anti-psychotic and considering going off it to lose wait -- don't. Your sanity and mental balance are far more important than a number on a scale. There are worse things in life than being a beautiful, happy, plus sized young lady.
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Replies
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Yes! Thank you for this!
However, I believe abilify does not list weight gain as a side effect. It is a relatively new drug though and I think it's still being evaluated. I was on abilify and did not gain any weight. That is, of course, anecdotal evidence.
I also think that mood stabilizers should be put on this list too. Many (not all) mood stabilizers are linked to weight gain. They are often taken alone or in conjunction with antidepressants and/or antipsychotics. Lithium, depakote and seraquil are known to increase appetite substantially. However, lamotrigine (commonly known as Lamictal) and geodon are weight neutral.
I agree with the the findings that many of these medications increase appetite, which may lead to weight gain. I was diagnosed Bipolar many years ago. Yes, I have gained some weight on a few of the medications. However, it was manly due to either me being depressed with no appetite, extremely manic with no appetite and running around like a mad, or even hallucinations that distracted me from eating. When on medications, many of my symptoms went away and I began to eat normal (sometimes more than normal) amounts of food, leading to weight gain.
Thank you for this post!
Edit: I'm not a functioning human being when off medication. When on medication, I can lead a normal life. Whenever a side effect is rough/undesirable, I make sure to speak with my doctor.
Communication with your clinician is key!5 -
My brother takes mood stabilizers and anti psychotics known to cause an increase in appetite. When he was in a hospital setting, he gained weight while eating hospital food and not getting much exercise. Now that he is home, eating Mom's cooking, helping her with extensive yard work, and walking several miles per day, he lost all the weight he gained and has maintained a healthy weight for almost two years.
He doesn't count calories. He does eat lots of whole foods - fruits, veggies, legumes, whole grains, etc. There's very little, if any, junk food in the house.1 -
I gained 80 pounds while on Abilify for bipolar. In my case, the excess weight was worsening my depression, so the doctor took me off of it and switched me to Latuda, which is weight-neutral. I have been able to lose weight while on the Latuda. MFP has been a huge factor in my weight loss; it was amazing how much I was eating before due to the increased appetite from Abilify. Luckily on the Latuda, I can stay within my allotted calories for weight loss and generally not have hunger or appetite issues.
There's no one-size-fits-all medication that will prevent weight gain. It's different for everyone. Abilify is supposed to be weight-neutral, but obviously that wasn't the case for me. I didn't gain any weight when I was on Seroquel, and that's supposed to be notorious for causing weight gain. It's crucial to work with your doctor and find what works best for you.4 -
I've been on seroquel for about 2.5 years and it definitely made me ravenous. my nighttime snacking got out of control and I put on 30 pounds. I had always been thin and been able to eat whatever I wanted and as much as I wanted without ever gaining a pound so it was hard to take. but I joined this site and started eating at a deficit and I've lost 25 of those 30 pounds. so it's not a life sentence! you can take control of the weight gain.9
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I was diagnosed BPII and went on Abilify. I gained 30 pounds over the year because I just couldn't overcome the never ending ravenous appetite I had. I would eat until I was stuffed, yet still was extremely hungry.
I went off Abilify cold turkey (highly not suggested for anyone to do) and spent 5 months of serious withdrawal symptoms (as an aside, you will go through them even titrating off the med) and finally came back to normal. My issue was I just didn't feel like me on it.
Now I am not medicating and taking my highs and lows as they come. I am also down ~40 pounds from watching my intake and exercising.1 -
i appreciate your input. anyone can feel free to add me as a friend; i have BiP disorder; i'm on Seroquel, hydroxyzine & zoloft.
the sero caused me to gain a huge amount of weight very rapidly. i had lost 16 lbs earlier this year (goal of losing 45)
then i started sero and gained 38 lbs pretty quickly, just about a little over a month.0 -
RespectTheKitty wrote: »I gained 80 pounds while on Abilify for bipolar. In my case, the excess weight was worsening my depression, so the doctor took me off of it and switched me to Latuda, which is weight-neutral. I have been able to lose weight while on the Latuda. MFP has been a huge factor in my weight loss; it was amazing how much I was eating before due to the increased appetite from Abilify. Luckily on the Latuda, I can stay within my allotted calories for weight loss and generally not have hunger or appetite issues.
There's no one-size-fits-all medication that will prevent weight gain. It's different for everyone. Abilify is supposed to be weight-neutral, but obviously that wasn't the case for me. I didn't gain any weight when I was on Seroquel, and that's supposed to be notorious for causing weight gain. It's crucial to work with your doctor and find what works best for you.
abilify and latuda did NOTHING for me. LOL funny how each is different.
also, lamictal caused me to be depressed (my dr said that was impossible...had to find a new dr. LOL)
sero is the only thing that works. unfortunately, i've gained close to 40 lbs since i started. yikes!0 -
RosieRose7673 wrote: »
Edit: I'm not a functioning human being when off medication. When on medication, I can lead a normal life. Whenever a side effect is rough/undesirable, I make sure to speak with my doctor.
Communication with your clinician is key!
i agree ^^ ^^
i can't function when unmedicated. you can add me as a friend if you like.
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I am Bipolar and have been on everything. I did gain weight on Depakote, but I also gained on Geodon.....or, did I just gain? It's hard to tease it all apart for me. Very complicated. Now I'm on Lithium (and Lamictal and Buspar and the occasional Valium) and I've lost 87 lbs.
For a long time I thought that I gained because of the medication and while I figure it did contribute to the gain (possibly a lot), I also know that I overate for lots of different reasons, not just the medication. I just plain ate A LOT. Always had. Now I don't. And I move. I haven't really moved in years.
I know that medication can cause weight gain. I watched my son balloon up overnight on Zyprexa. As soon as he stopped the drug he lost all the weight, over night. My current shrink doesn't want me to come even close to Seroquel, even though I've always used it as a rescue drug in the past and never had any difficulty.
I think it's important to not use medication as an "excuse" to NOT lose weight. For someone who puts on 30 lbs in a month--well you're like my son on Zyprexa. But for someone like me who is bipolar and gains the weight over a few years--not the same thing at all.2 -
I spent about 6 months each on risperdone and seroquel. I don't recall gaining any weight on either, though. I think I was too busy sleeping. Guess everyone responds differently.
The other side effects, however, were honestly worse than the voices, so I went off them. Antipsychotics are nasty drugs.
I did have significant weight gain on all the SSRIs I tried. During the first few months I was on celexa I gained ~40 lbs. Bupropion is the only med that makes me lose weight.2 -
Rapid cycling BADII here. Before diagnosis I was put on mirtazapine (amongst others at various points) and gained I think more than 10lbs in a month, it made me ravenous for sweet things. Turns out they use it as an appetite stimulant in cats and dogs!
Then when I got diagnosed I was put on seroquel and gained even more weight (and I started being a bit overweight anyway). Meds never made me function any better and so I titrated off after two years of experimenting to see how managing myself now I knew my diagnosis would go.
I am now off meds and learning to self manage. I still function in a pretty perfunctory way but am finding strategies and ways to keep going. I'm hopeful to return to some sort of work at some point but we'll just see how that goes.
Biggest thing for me has been getting control of my physical health. It has helped hugely with my mental health and exercise has certainly evened out my highs and lows to a degree. I'll take that! And I'm finally getting rid of the med weight and the extra weight I always had as an adult. That in and of itself is pretty empowering when your mind is something you don't have too much control of.4 -
VintageFeline wrote: »Rapid cycling BADII here. Before diagnosis I was put on mirtazapine (amongst others at various points) and gained I think more than 10lbs in a month, it made me ravenous for sweet things. Turns out they use it as an appetite stimulant in cats and dogs!
Then when I got diagnosed I was put on seroquel and gained even more weight (and I started being a bit overweight anyway). Meds never made me function any better and so I titrated off after two years of experimenting to see how managing myself now I knew my diagnosis would go.
I am now off meds and learning to self manage. I still function in a pretty perfunctory way but am finding strategies and ways to keep going. I'm hopeful to return to some sort of work at some point but we'll just see how that goes.
Biggest thing for me has been getting control of my physical health. It has helped hugely with my mental health and exercise has certainly evened out my highs and lows to a degree. I'll take that! And I'm finally getting rid of the med weight and the extra weight I always had as an adult. That in and of itself is pretty empowering when your mind is something you don't have too much control of.
Glad you are finding your way. Take special care. -r.0 -
As a pharmacist, I feel like I need to step in and clear some information in the original post... I feel like this post might be an offshoot of the "lexapro and weight-gain" thread where I commented, so if anyone is interested please look there.
No, anti-psychotics should not be confused with other antidepressants like SSRIs, but they are NOT all created equal. There are your typical (or first-generation) anti-psychotics and your atypical (second-generation) antipsychotics. No they do not all cause significant weight gain. I don't mean to shout, but this being a weight-loss forum, I hate to see mis-information like this spread.
The second-gen antipsychotics are the ones more associated with metabolic side effects like weight-gain and hyperglycemia, but not all of them cause it to the same degree. Some have very low effects in this department. Zyprexa and clozapine are two of the worst offenders. To say sixty pounds the first year is common for antipsychotics is not accurate whatsoever. I really would like the actual studies this information is from. I'd like to look at the methodology and the actual conclusions that can be drawn from the paper- often the media sensationalizes results or draws conclusions that can't be drawn.
My heart goes out to your niece and I'm so glad she has something that works for her- that is wonderful. I personally know several people who have schizophrenia and it can be very debilitating and extremely frightening. Ultimately, you're right- you need to weigh what's more important for you- taking care of mind and body.
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When I started taking medication for bipolar I gained a lot of weight. Now, I am doing my best to lose weight for my health's sake. Since I gained weight I find it hard to climb the stairs, my feet hurts when I stand too long. I cant run. I will not accept being fat because it is not healthy.4
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As a pharmacist, I feel like I need to step in and clear some information in the original post... I feel like this post might be an offshoot of the "lexapro and weight-gain" thread where I commented, so if anyone is interested please look there.
No, anti-psychotics should not be confused with other antidepressants like SSRIs, but they are NOT all created equal. There are your typical (or first-generation) anti-psychotics and your atypical (second-generation) antipsychotics. No they do not all cause significant weight gain. I don't mean to shout, but this being a weight-loss forum, I hate to see mis-information like this spread.
The second-gen antipsychotics are the ones more associated with metabolic side effects like weight-gain and hyperglycemia, but not all of them cause it to the same degree. Some have very low effects in this department. Zyprexa and clozapine are two of the worst offenders. To say sixty pounds the first year is common for antipsychotics is not accurate whatsoever. I really would like the actual studies this information is from. I'd like to look at the methodology and the actual conclusions that can be drawn from the paper- often the media sensationalizes results or draws conclusions that can't be drawn.
Thanks for this post. As a registered nurse with bipolar type 1 who has gained on a number of atypical antipsychotics (abilify, ridperidone, quietapine, palperidone, olanzapine) and has extensively researched all medications I have been prescribed, you've covered a few points I would have liked to mention.
I currently am back on lithium monotherapy and have been able to lose all the weight I gained 15+kg on atypical antipsychotics.
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You're all AMAZING... I love the openness in this feed
We are what we are.... We do our best to work with ourselves. Losing weight is hard enough but dealing with mental health problems is another level. Stay strong.... We can do this! 
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I love this thread. I am BP 1 ultra rapid cycler with mixed features. I also have PMDD. I am always on a meds rollercoaster! Some meds make me ravenous others are neutral. But I'm usually on 6-10 meds so sometimes the culprits are difficult to identify. It's a slow and extremely painful process, especially when your life is on the line. It got so bad for me recently and no meds we're working I had to Have ECT to get me out of manic psychosis.
Everyone stay strong! I have successfully lost 60lbs. I'm now an exercise junkie. It helps manage the stress and reduce the triggers substantially. I still have moderate symptoms. I'm extremely depressed post mania but I surrender to each moment and know that everything is transient.
Good luck everyone! And thanks for sharing!1 -
I started on Abilify last fall and have lost just about 70 lbs since January. It has completely taken away my appetite and cravings. But I tend to be the exception to the rule with most medications.0
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I've put on 4 stone since being on antipsychotics. I know the Drs and researchers debate this (who funds research i wonder...kerching!! I've done my own research at uni and helped others with theirs, I know how it goes).
It's about time the medical profession listened to the patients. Nearly everyone I speak to that is taking antipsychotics has put on weight (I worked at a mental health unit too so I talk to a lot of people that take antispychotics)
I understand that inactivity is part of it (I used to work and be very active at work) but I have been carb craving like no tomorrow. Cereal...I can't eat enough cereal. There seems to be a sensory aspect to this I think...I love the swallowing feeling, and drink a load of coffee too (decaf).
I'm not sure how the very rich and powerful pharmaceutical companies do their research (not sarcastic at all), but the research is only as good as the researchers and their motives. I'm trying my best to come of Quetapine with the support of my PDoc and then I shall tackle the dreaded Sertraline. I am not anti medication, but my meds have never addressed my problems it was therapy that I found helpful. The side effects are more dangerous than my 'condition', But that is my take on things and my choice.
Also should add, if antipsychotics are not a contributing factor in weight gain why was my PDoc considering switching my meds to one that 'has less effect on weight gain'?
Here's one with just a simple google search...it's not very well written, but it is what a lot of people seem to agree with.
https://www.bap.org.uk/articles/antipsychotic-medication-and-weight-gain/1 -
I've gained and lost a lot of weight on antipsychotics and mood stabilizers.. I find when i'm happy and not anxious/paranoid, i'm able to diet and exercise more and do better with weight management -- in the past while on these meds i've gone from 265 down to about 175.. Then i ran into issues... And now i'm back around 220-225... Lately have been doing OK but the past couple of years have been -- so-so mental health wise. Right now i'm ALSO dealing with OTHER health issues besides mental health though, and taking meds (not sure how long) which may lead to weight gain. BTW- I'm just getting started again and will accept pretty much any friend adds.3
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