Maintaining on Antipsychotics
DragonHasTheSapphire
Posts: 184 Member
Is anyone else out there taking antidepressants or antipsychotics and losing/maintaining? I just started taking some, and I am well aware there could be little to a lot of weight gain, so I'll be monitoring my weight as I wish to maintain or at least be at a reasonable weight without it spiraling out of control.
I asked my doctor about it, but she said everyone's different.. and she's right. Exercise and a healthy diet is all you can do.
I asked my doctor about it, but she said everyone's different.. and she's right. Exercise and a healthy diet is all you can do.
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Replies
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I take lamotrigine and Seroquel. If a medication is going to cause you to gain weight, it's generally because of increased appetite or water retention, so I would watch my calories closely for a while to make sure I wasn't eating over maintenance. Water weight will most likely resolve on it's own. My experience with the meds was noticeable increased appetite in the first few months, but that didn't last and I eventually dropped back into my usual eating patterns. Hugs, hope the meds work for you
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I take lamotrigine and Seroquel. If a medication is going to cause you to gain weight, it's generally because of increased appetite or water retention, so I would watch my calories closely for a while to make sure I wasn't eating over maintenance. Water weight will most likely resolve on it's own. My experience with the meds was noticeable increased appetite in the first few months, but that didn't last and I eventually dropped back into my usual eating patterns. Hugs, hope the meds work for you
Thanks for the advice. I have also noticed increased appetite on this medicine, I'll be making sure my logging is as accurate as possible! 2 -
Lamotrigine has me pretty stable and doesn't seem to affect appetite much. Most of my binges were when I was depressed and better judgement keeps me from justifying things like I do when hypomanic so it helped.. Not on any AP now. Was on Saphris a little while. Tried latuda and had akathisia. Neither of those seemed to affect appetite much. I know I am not cured and some swings are still going to happen and I have to admit I am a little worried about keeping the weight down when that happens.3
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I watched my Mom for about 60-70 years struggle with bi polar disorder. She was on so many different meds including lithium for many years which really didnt seem to work but which I think contributed to her dementia starting in her 70's. After moving to Austin in 2003 with my Dad they started the lamotrigine and seroquel meds and I have to say they seemed to work better than any and all of the previous ones. Not sure if they helped with the weight but they definitely kept her from going off the deep end manic or depressive.2
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CarvedTones wrote: »Lamotrigine has me pretty stable and doesn't seem to affect appetite much. Most of my binges were when I was depressed and better judgement keeps me from justifying things like I do when hypomanic so it helped.. Not on any AP now. Was on Saphris a little while. Tried latuda and had akathisia. Neither of those seemed to affect appetite much. I know I am not cured and some swings are still going to happen and I have to admit I am a little worried about keeping the weight down when that happens.
I hope the best goes through to your path. *Hug* I'm currently taking 0.5mg of Risperidone and it makes me want to devour everything, but I've been using strong self-control to not overeat because it's just the medication. I've been on Trinessa birth control and it made me quite ravenous the first few months, but after a while my appetite returned to normal, hopefully the psychiatric meds do the same. 1 -
SummerSkier wrote: »I watched my Mom for about 60-70 years struggle with bi polar disorder. She was on so many different meds including lithium for many years which really didnt seem to work but which I think contributed to her dementia starting in her 70's. After moving to Austin in 2003 with my Dad they started the lamotrigine and seroquel meds and I have to say they seemed to work better than any and all of the previous ones. Not sure if they helped with the weight but they definitely kept her from going off the deep end manic or depressive.
I understand, I have a grandmother who suffers from Bipolar Disorder as well, which I believe she's taken some of those medications in the past, too (she also has Schizophrenia, which is why she's in the hospital every few months
) When I went for my visit the psychiatrist she ruled out mood disorders, so I actually have a personality disorder that's similar to Bipolar. From what I've seen with my grandmother, she gained a lot of weight from her medications but I'm sure it was from increased appetite in combination with switching them up so often. 3 -
It's not easy with the meds! Make sure your thyroid is in normal range too. Everyone is different in how hormones and psych meds work. I gained a lot on zyprexa most of these meds raise your sugar docs are starting to monitor weight and diabetes more. Always keep good communications with your doctors.2
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It's not easy with the meds! Make sure your thyroid is in normal range too. Everyone is different in how hormones and psych meds work. I gained a lot on zyprexa most of these meds raise your sugar docs are starting to monitor weight and diabetes more. Always keep good communications with your doctors.
Oh yes, I got some bloodwork done in April and my thyroid seems to be in healthy condition. One of my hormone levels is quite low though, which is why I have to use hormone therapy to get cycles every month. I've been taking Trinessa for the hormone issue, and have been able to lose weight, but got switched to Lo Lesterin Fe and everything kinda got out of whack, so I went back on my original meds and it seemed well again *whew* My doctor says she's going to do routine blood tests to prevent some of those problems, so connections are set. One thing I've been curious about is if I could do a "special" diet might help, but I'm not entirely sure. 1 -
Ziprasidone (GEODON) & Aripiprazole (ABILIFY) have the least weight gain association according to Meta Analysis comparison of antipsychotics (1st & 2nd generation agents). Risperidone 0.5mg is on the very low end of the dosing range (can go up to 8mg/day). Have one good patient who regularly mentions his success with weight loss on ziprasidone vs other antipsychotics (can make a big difference for some).
Might want to talk to your MD; this is not as simple a interchange even though these drugs are both considered 2nd generation antipsychotics (very variable person to person because of the different receptor binding affinities (ki) among the various antipsychotics). Ziprasidone may have less weight gain & less gynecomastia (excess breast tissue, lactation risks too) but have a slightly greater QTc prolongation risk (not good if you have arrhythmia history or EKG QT (corrected) >= 500ms). I will say that both Ziprasidone & Risperidone are structurally closer to each other; both "-dones" as opposed to the "-pines" (as in quetiapine, olanzapine, clozapine (whole other "mystical unicorn" of a drug), etc.)6 -
Forgot to mention, others I have on Ziprasidone (dozen +) are fairly skinny/not-overweight in appearance. I do keep track of stuff like this out of boredom (need to pass the time somehow but keeping in touch with drug trends/associations). Again, this is association, not causation from observation only. There is meta analysis data to support this trend though2
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I used to take various ADs over the years when I was in denial and pretended to just have depression and ADHD (which I do have) because of social stigma. If you tell people you have depression they try to cheer you up. If you tell them you have ADHD they shrug and maybe roll their eyes. Tell them you have bipolar disorder and they hide the knives. Anyway, most SSRIs made me pig out. Wellbutrin, which is not an SSRI, actually helped with weight control. But as soon as ADs hit effective level they make me hypo and not the fun happy kind, the irritable kind. Some of the ADHD meds help with suppressing appetite, but I abused stimulants and had to switch to straterra which is appetite neutral.
With all due respect to the good doc who posted, it's good to get a second or even third opinion. Mental disorders are really hard to diagnose and it is not unusual to be knee deep in meds for one condition and see another doc that diagnoses something completely different.
I forgot Abilify is an AP. I was on that for a little while. I am not sure why I get APs in the mix sometimes. I get some delusions sometimes (like being immortal) but not full blown psychosis.4 -
I was on Abilify for a short while for Bipolar II and it increased my appetite significantly. I was able to maintain a healthy diet during the day, but I found myself waking up at night and eating everything in the fridge, which is not normal behavior for me. I asked to be taken off of it because it was causing me a ridiculous amount of anxiety, and currently I am losing the weight I gained during that month. It is frustrating when you have a Pyschiatrist who isn't very concerned about weight gain as a side effect, and I am actually switching to a new one as of next month.3
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It's kind of hard for me to be sure what was caused by meds and what was caused by drinking while depressed. I have been over a year sober and lost ~65 pounds; I don't think this is a coincidence. I would closet drink late at night and then make nachos and while they were in the toaster oven I might have a bowl of chocolate moose tracks ice cream with some oreos...5
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Aripiprazole is slightly different than the other 1st & second generation antipsychotics in that it is a dopamine-2 system modulator/partial agonist (as opposed to dopamine-2 antagonist); more prone to causing parkinsonian like extrapyramidal symptomds, tardive dyskinesia, risk/reward behavior (gambling, shopping, hypersexuality), etc. akin to traditional dopamine agonists (carbidopa, ropinirole, rotigotine, etc.).
Newer drug Brexpiprazole (REXULTI) is essentially an 'upgraded' version of ariripiprazole, structurally made more towards the antagonist spectrum (less prone to agonist like side effects); additionally has a much more straight forward dosing scheme with drug interactions/enzyme substrate interactions already accounted for.
(Does not understand people who woo scientific facts taken straight from the package insert...get a life)2 -
Keto_Vampire wrote: »Ziprasidone (GEODON) & Aripiprazole (ABILIFY) have the least weight gain association according to Meta Analysis comparison of antipsychotics (1st & 2nd generation agents). Risperidone 0.5mg is on the very low end of the dosing range (can go up to 8mg/day). Have one good patient who regularly mentions his success with weight loss on ziprasidone vs other antipsychotics (can make a big difference for some).
Might want to talk to your MD; this is not as simple a interchange even though these drugs are both considered 2nd generation antipsychotics (very variable person to person because of the different receptor binding affinities (ki) among the various antipsychotics). Ziprasidone may have less weight gain & less gynecomastia (excess breast tissue, lactation risks too) but have a slightly greater QTc prolongation risk (not good if you have arrhythmia history or EKG QT (corrected) >= 500ms). I will say that both Ziprasidone & Risperidone are structurally closer to each other; both "-dones" as opposed to the "-pines" (as in quetiapine, olanzapine, clozapine (whole other "mystical unicorn" of a drug), etc.)
Right now Risperidone is what's being tested right now, if I don't do well on this drug then I'll be said to switch up to Abilify and see how that goes, my mom took this and it worked well without much weight gain (maybe 5 lbs at most).
I have also read that atypical antipsychotics are usually associated with more weight gain than the older typical kinds, but the antipsychotic I'm taking now I'm seeing some progress going on, but I will discuss this at my next appointment, thanks for the useful info.!1 -
CarvedTones wrote: »I used to take various ADs over the years when I was in denial and pretended to just have depression and ADHD (which I do have) because of social stigma. If you tell people you have depression they try to cheer you up. If you tell them you have ADHD they shrug and maybe roll their eyes. Tell them you have bipolar disorder and they hide the knives. Anyway, most SSRIs made me pig out. Wellbutrin, which is not an SSRI, actually helped with weight control. But as soon as ADs hit effective level they make me hypo and not the fun happy kind, the irritable kind. Some of the ADHD meds help with suppressing appetite, but I abused stimulants and had to switch to straterra which is appetite neutral.
With all due respect to the good doc who posted, it's good to get a second or even third opinion. Mental disorders are really hard to diagnose and it is not unusual to be knee deep in meds for one condition and see another doc that diagnoses something completely different.
I forgot Abilify is an AP. I was on that for a little while. I am not sure why I get APs in the mix sometimes. I get some delusions sometimes (like being immortal) but not full blown psychosis.
I totally understand what you've gone through, when I told my friends and family about the diagnosis of Borderline Personality Disorder it's like they're walking on eggshells around me, some think it makes people crazy. My brother has Antisocial Personality Disorder and gets a similar reaction. Ugh.
For my birth control I started taking them as young as 11, and I'm 19 now. Around 16 for those 5 years I gained serious weight because I would scoff down so much food because of the appetite, so the hunger is quite similar to the hunger in AD and AP! I was offered an appetite suppresant to control the weight 3 years ago, but my mother had me decline it and suggested that I just try and lose weight without medication.
When I was at the hospital for mental health issues, they told me I had Anxiety and Depression with paranoia. Yet when I see a psychologist and a psychiatrist they both think I don't have a mood disorder, so that's when the conclusion of BPD came into mind, not even including any co-occuring disorders.. It can be confusing. I'm at high risk of developing Schizophrenia because I already have paranoia and paranoid ideation, but I've had that for years.. And some persecutory delusions as well.0 -
I was on Abilify for a short while for Bipolar II and it increased my appetite significantly. I was able to maintain a healthy diet during the day, but I found myself waking up at night and eating everything in the fridge, which is not normal behavior for me. I asked to be taken off of it because it was causing me a ridiculous amount of anxiety, and currently I am losing the weight I gained during that month. It is frustrating when you have a Pyschiatrist who isn't very concerned about weight gain as a side effect, and I am actually switching to a new one as of next month.
I'm experiencing the same behavior on Risperidone, except I usually ignore the hunger pangs and I'll find myself thinking, "Did I eat too few calories or something? No.. It's just the medicine." The day seems fine though, but I have to eat as soon as I'm up because my stomach will feel like a bottomless pit in the morning, which I hate. My psychiatrist isn't too concerned about weight gain either, but the mental side effects or the effects it might have on your organs. I'm on 0.5 mg right now, but she said she's going to increase my dosage slowly to 1 mg, and so on. I just hope my hunger doesn't stick around for too long, it might dissipate after my body gets used to it but I'm not too sure if that'll happen since this isn't anything like the birth control I take.1 -
DragonHasTheSapphire wrote: »CarvedTones wrote: »I used to take various ADs over the years when I was in denial and pretended to just have depression and ADHD (which I do have) because of social stigma. If you tell people you have depression they try to cheer you up. If you tell them you have ADHD they shrug and maybe roll their eyes. Tell them you have bipolar disorder and they hide the knives. Anyway, most SSRIs made me pig out. Wellbutrin, which is not an SSRI, actually helped with weight control. But as soon as ADs hit effective level they make me hypo and not the fun happy kind, the irritable kind. Some of the ADHD meds help with suppressing appetite, but I abused stimulants and had to switch to straterra which is appetite neutral.
With all due respect to the good doc who posted, it's good to get a second or even third opinion. Mental disorders are really hard to diagnose and it is not unusual to be knee deep in meds for one condition and see another doc that diagnoses something completely different.
I forgot Abilify is an AP. I was on that for a little while. I am not sure why I get APs in the mix sometimes. I get some delusions sometimes (like being immortal) but not full blown psychosis.
I totally understand what you've gone through, when I told my friends and family about the diagnosis of Borderline Personality Disorder it's like they're walking on eggshells around me, some think it makes people crazy. My brother has Antisocial Personality Disorder and gets a similar reaction. Ugh.
For my birth control I started taking them as young as 11, and I'm 19 now. Around 16 for those 5 years I gained serious weight because I would scoff down so much food because of the appetite, so the hunger is quite similar to the hunger in AD and AP! I was offered an appetite suppresant to control the weight 3 years ago, but my mother had me decline it and suggested that I just try and lose weight without medication.
When I was at the hospital for mental health issues, they told me I had Anxiety and Depression with paranoia. Yet when I see a psychologist and a psychiatrist they both think I don't have a mood disorder, so that's when the conclusion of BPD came into mind, not even including any co-occuring disorders.. It can be confusing. I'm at high risk of developing Schizophrenia because I already have paranoia and paranoid ideation, but I've had that for years.. And some persecutory delusions as well.
I got my first BP II diagnosis a very long time ago and decided it was bogus and went to another doctor, answered the questions about hypomania a little more creatively and got it attributed to ADHD. I was kind of lucky to get an episode of expansive hypomania early last year and was wide open with my wife and kids about my closet drinking and stimulant abuse because I was sure they would understand why it made sense for me. I also told my primary, who promptly cancelled the stimulants and sent me to see a psychiatrist. I was sure the psychiatrist would understand and set everybody straight. That's not exactly what happened. That episode lasted several weeks and I actually enjoyed it until I crashed and didn't have alcohol to numb me out at night while I was depressed; I managed to ride through it sober. After I was up to the therapeutic dose of lamictal I pulled out of the depression without getting hypo. I still have some ups and downs but haven't had a bad episode of either in a year.
It kind of sucks to have your brain do different things than you want. When I was younger, I was one of the eye rollers who thought people were getting medicated for personality flaws they could fix or just to get attention. Kind of veered off the subject, but I bounce around a lot even when stable (ish).2 -
CarvedTones wrote: »DragonHasTheSapphire wrote: »CarvedTones wrote: »I used to take various ADs over the years when I was in denial and pretended to just have depression and ADHD (which I do have) because of social stigma. If you tell people you have depression they try to cheer you up. If you tell them you have ADHD they shrug and maybe roll their eyes. Tell them you have bipolar disorder and they hide the knives. Anyway, most SSRIs made me pig out. Wellbutrin, which is not an SSRI, actually helped with weight control. But as soon as ADs hit effective level they make me hypo and not the fun happy kind, the irritable kind. Some of the ADHD meds help with suppressing appetite, but I abused stimulants and had to switch to straterra which is appetite neutral.
With all due respect to the good doc who posted, it's good to get a second or even third opinion. Mental disorders are really hard to diagnose and it is not unusual to be knee deep in meds for one condition and see another doc that diagnoses something completely different.
I forgot Abilify is an AP. I was on that for a little while. I am not sure why I get APs in the mix sometimes. I get some delusions sometimes (like being immortal) but not full blown psychosis.
I totally understand what you've gone through, when I told my friends and family about the diagnosis of Borderline Personality Disorder it's like they're walking on eggshells around me, some think it makes people crazy. My brother has Antisocial Personality Disorder and gets a similar reaction. Ugh.
For my birth control I started taking them as young as 11, and I'm 19 now. Around 16 for those 5 years I gained serious weight because I would scoff down so much food because of the appetite, so the hunger is quite similar to the hunger in AD and AP! I was offered an appetite suppresant to control the weight 3 years ago, but my mother had me decline it and suggested that I just try and lose weight without medication.
When I was at the hospital for mental health issues, they told me I had Anxiety and Depression with paranoia. Yet when I see a psychologist and a psychiatrist they both think I don't have a mood disorder, so that's when the conclusion of BPD came into mind, not even including any co-occuring disorders.. It can be confusing. I'm at high risk of developing Schizophrenia because I already have paranoia and paranoid ideation, but I've had that for years.. And some persecutory delusions as well.
I got my first BP II diagnosis a very long time ago and decided it was bogus and went to another doctor, answered the questions about hypomania a little more creatively and got it attributed to ADHD. I was kind of lucky to get an episode of expansive hypomania early last year and was wide open with my wife and kids about my closet drinking and stimulant abuse because I was sure they would understand why it made sense for me. I also told my primary, who promptly cancelled the stimulants and sent me to see a psychiatrist. I was sure the psychiatrist would understand and set everybody straight. That's not exactly what happened. That episode lasted several weeks and I actually enjoyed it until I crashed and didn't have alcohol to numb me out at night while I was depressed; I managed to ride through it sober. After I was up to the therapeutic dose of lamictal I pulled out of the depression without getting hypo. I still have some ups and downs but haven't had a bad episode of either in a year.
It kind of sucks to have your brain do different things than you want. When I was younger, I was one of the eye rollers who thought people were getting medicated for personality flaws they could fix or just to get attention. Kind of veered off the subject, but I bounce around a lot even when stable (ish).
I'm sorry you had to go through that. I can kinda understand about your switching moods, but mine are moment-to-moment and extremely intense. I'm not sure if you saw, but I do have a family member with Bipolar II, so I can feel your pain there. Last year my grandma had a horrible episode that made her impulsive without thinking things through, it almost killed her once.
You aren't the only one who thought the same way about personality disorders, I thought the idea of them was just for attention-deprived people to get attention they wanted, but was pretty much nailed by a psychologist about that matter. XD0
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