Anti-psychotic meds and weight gain.

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.
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Replies

  • kshama2001
    kshama2001 Posts: 28,052 Member
    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.
  • RespectTheKitty
    RespectTheKitty Posts: 1,667 Member
    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.
  • Beaner63
    Beaner63 Posts: 69 Member
    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.
  • markswife1992
    markswife1992 Posts: 262 Member
    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.
  • markswife1992
    markswife1992 Posts: 262 Member
    edited May 2016
    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!
  • markswife1992
    markswife1992 Posts: 262 Member

    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.

  • godlikepoetyes
    godlikepoetyes Posts: 442 Member
    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.
  • tohrunkimi
    tohrunkimi Posts: 1 Member
    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.
  • VintageFeline
    VintageFeline Posts: 6,771 Member
    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.
  • godlikepoetyes
    godlikepoetyes Posts: 442 Member
    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.
  • 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.
  • crackpotbaby
    crackpotbaby Posts: 1,297 Member
    Dove0804 wrote: »
    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.
  • Panda8ach
    Panda8ach Posts: 518 Member
    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! <3
  • KristyDonovan
    KristyDonovan Posts: 67 Member
    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!
  • ZhivagosGirl
    ZhivagosGirl Posts: 161 Member
    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.
  • candchughes
    candchughes Posts: 17 Member
    edited November 2017
    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/
  • robwilkens42
    robwilkens42 Posts: 8 Member
    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.
  • toomuchcider
    toomuchcider Posts: 3 Member
    I was prescribed Olanzapine (Zyprexa) during an episode of severe anxiety in 2016. I was on a small dose (2.5 mg) for about nine months, then weaned myself off it in the summer of last year.

    For me, the drug was a life-saver. It calmed me down, helped me sleep, really pulled me back from the brink of something much worse.

    However, the weight gain.... ouch. I put on at least 40 lbs. I've joined MFP as part of an effort to get back to my pre-episode weight of 175 lbs. I've lost about 9 lbs so far since the beginning of this year and feel good.

    This link I found on a different forum but I thought I'd share as it's interesting:

    mentalhealthdaily.com/2015/01/31/zyprexa-and-weight-gain-how-it-causes-you-to-get-fat/

    In it says:

    "A review of evidence revealed that the average amount of weight gained over the course of 2 years on Zyprexa typically ranges between 6 lbs. and 13 lbs."

    Which sounds ridiculously low. All the people I've chatted to on other (mental health) forums have experienced significant and dramatic weight gain. And, for some, the resulting problems with blood sugar / type 2 diabetes etc.

    In short - it's a great drug but the side effects...

    What's strange is that despite coming off the drug in August of last year, I'm still experiencing the same cravings / increased appetite. I never used to want to snack like this! The evenings are the worst.

    Anyway.... good luck to everyone here. Hope you're successful on your journeys.
  • Iwantahealthierme30
    Iwantahealthierme30 Posts: 293 Member
    Zyprexa is the devil, I gained 40 pounds on it in 2 months 14 years ago. No one should take that drug, I'm surprised it's still prescribed. No experience with abilify but I decided not to take it due to problems other people have had with it. Currently on Seroquel 100mg and Loxapine 10 mg and have lost 14 pounds in 65 days,
  • thegeordielass
    thegeordielass Posts: 208 Member
    I guess I should consider myself reasonably lucky then! I recall having a big discussion with my psychiatrist before I started anything about pros/cons of each option and I was told there was the likelihood of some weight gain with some (OK, most!) and it could possibly be about 20ish lbs over a year.
    First med I went on was lamotrigine where I actually lost weight (10lbs) as I had no appetite at all and I'd go for days at a time just forgetting to eat unless someone cooked for me or prompted me as I just didn't get hungry. Sadly that didn't work and I ended up adding in quetiapine. I gained back the 10lbs I lost when I started that but to be honest, I think most is the fact that with my appetite returned to normal I got back into my old comfort binge eating means of coping with things. I'm currently 20lbs down on my highest weight - 15 of which was with no real effort at all on my part and 5 of which was this Jan when my eating was less than spotless. Hopefully if I can keep away from chocolate (I literally have no self control) and keep up with the exercise it'll drop off like it did last time I lost weight. This time I have thyroid problems to add into the mix too though.
  • mburgess458
    mburgess458 Posts: 480 Member
    I don't know about the other anti-psychotics, but for Risperidone (Risperdal) the weight gain isn't only caused by increased appetite. My autistic and intellectually disabled son has taken Risperidone for years now. He has eating issues and only eats what we give him... due to autism he only wants to eat the things he is used to in the amounts he is used to. When he started on Risperidone his calories consumed did not change at all. No increase at all, he ate exactly the same things in the same amounts but he gained 10-15 lbs (he is tiny so it was about 10% to 15% of his weight). We lowered his calories a little and over time the weight came off. Several years later we had to increase his dosage of Risperidone and the exact same thing happened again.

    I don't know if he was hungrier or not, but he absolutely did NOT consume a single calorie more. Of course his weight gain was more like 10-15% of body-weight not the amounts others have seen on other anti-psychotics but there was weight gain with no increase in calories consumed.

    Also, he seemed to be just as active as before when he was gaining weight. It isn't like he was sluggish and lazing around after going on the drug compared to running nonstop before.
  • etherealanwar
    etherealanwar Posts: 465 Member
    When I was first prescribed antipsychotics I was put on seroquel and gained 40 lbs in a matter of a few months within the hospital. Once out of the hospital I was put on Abilify and have been on it for several years. I've been through phases of going off and on the medication because I despised the weight gain and the way it made me feel like a zombie with no energy. I switched over to Latuda and depakote now and gained a further 20 lbs to the point that I had enough. I'm not sure whether its only the increase of appetite that causes the weight gain or if it also slows down the metabolism. I decided to lose weight using MFP two months ago and I'm down 11 lbs so there seems to be some hope.

    I cannot survive without my medications so I will try my best to lose the weight.
  • EatingAndKnitting
    EatingAndKnitting Posts: 531 Member
    I believe that mood stabilizers and anti psychotics that cause weight gain when the diet hasn't changed, such as in the comment two above me that it's changing the CO side of the CICO equation. This is just a personal theory of mine, based on my experience with Abilify.

    I lost 70 pounds with WW while just on Cymbalta. I gained it back when my bipolar disorder got bad, was diagnosed with bipolar disorder and put on Abilify.

    I tried WW again, I followed the program exactly right. I measured all my foods (using cups, which wrong, but better than I was previously doing), I tracked every point for two months. I lost no weight. I was eating the same things in the same quantities as I was when I list 70 pounds, I wasn't any hungrier at all, but I couldn't lose weight. If I was indeed doing everything right, my leader said I was (she looked at my logs), and I couldn't lose, the only thing I can think of is that maybe the medication made my body a little more efficient at burning calories, so I was still eating too much.

    Maybe I'm full of *kitten*. If I am, please tell me, I'm genuinely curious and never remember to Google this.

    I should have tried dropping my points a few and see if that made a difference. Or measured with a scale. Ah, if I knew then what I know now...

    My doctor eventually took me off Abilify and put me on Geodon. I sorta tracked, kind of half-assed it last year and dropped 50 pounds. Again the only real change was my medication, and I stuck to it longer.
  • toomuchcider
    toomuchcider Posts: 3 Member
    @jesslla

    Yes, according to this article the problem is that not only does it increase appetite, but also:

    - Slows the metabolism.
    - Alters levels of blood glucose & hormones.
    - Disrupts your gut 'microbiome'.

    All of which can lead to weight gain no matter how well you maintain the CI side of the CICO equation.
  • Slowfaster wrote: »
    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.

    I got to around 330 on antipsychotics. I have always been heavier but i gained 120 on resperidal and that was way worse than the very shortlived symptoms i had. I believe i am misdiagnosed. (That's another subject). i can't think of much worse than being over 300 lbs and then having a psych doctor who doesn't take it seriously.
  • WillingtoLose1001984
    WillingtoLose1001984 Posts: 240 Member
    edited January 2018
    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.


    Being over 100 lbs overweight really takes a toll on you in every area and I believe it is worse than some, not all, mental health symptoms. If I can't walk or work than what benefit am i really getting from the medication? Ive lost 50 lbs since getting off the antipsychotics and still feel like my weight gets in the way of important things.
  • jesslla wrote: »
    I believe that mood stabilizers and anti psychotics that cause weight gain when the diet hasn't changed, such as in the comment two above me that it's changing the CO side of the CICO equation. This is just a personal theory of mine, based on my experience with Abilify.

    I lost 70 pounds with WW while just on Cymbalta. I gained it back when my bipolar disorder got bad, was diagnosed with bipolar disorder and put on Abilify.

    I tried WW again, I followed the program exactly right. I measured all my foods (using cups, which wrong, but better than I was previously doing), I tracked every point for two months. I lost no weight. I was eating the same things in the same quantities as I was when I list 70 pounds, I wasn't any hungrier at all, but I couldn't lose weight. If I was indeed doing everything right, my leader said I was (she looked at my logs), and I couldn't lose, the only thing I can think of is that maybe the medication made my body a little more efficient at burning calories, so I was still eating too much.

    Maybe I'm full of *kitten*. If I am, please tell me, I'm genuinely curious and never remember to Google this.

    I should have tried dropping my points a few and see if that made a difference. Or measured with a scale. Ah, if I knew then what I know now...

    My doctor eventually took me off Abilify and put me on Geodon. I sorta tracked, kind of half-assed it last year and dropped 50 pounds. Again the only real change was my medication, and I stuck to it longer.

    Geodon actually totally took away my appetite. They took me off it though. Abilify actually gave me symptoms I didn't usually have so I went off. Latest I was on haldol and started gaining, 40 lbs in 2 or 3 months. I think the histamine problem that was mentioned happens to me.