Saturday, July 9, 2011

Saturday July 9th 2011 - Weight gain associated with Bipolar medications

Weight gain is one of the most common and difficult side effects of many of the medications used to treat bipolar disorder and other psychiatric illness. The most common types of bipolar meds are atypical anti-psychotics, anti-depressants, anti-anxiety, anti-manics or “Mood Stabilizers” and anti-seizure medications.  

When I was initially diagnosed as Bipolar in 2001, my psychiatrist put me on a combination of anti-psychotics including Seroquel, Lithium, Depakote, and clozapine. All of these drugs are in the highest weight gain risk group. I was already obese, but these drugs made it impossible to lose weight. True to the claims, I gained weight like a sumo wrestler. 

Through the years I have adjusted my bipolar "menu" to Lamictal, Hydroxyzine, Seroquel, and Lorazepam. Lamictal is an anti-manic mood-stabilizer. Hydroxyzine and Lorazepam are anti-anxiety meds. Seroquel is an anti-psychotic. I've been on these drugs for over four years and they are very effective. I still suffer from the symptoms of being manic-depressive and I still have panic attacks, but I'm not totally incapacitated by them. I'm sure that I would be incapacitated and a puddle of useless poop without these medications. 

I have borrowed the following quick reference guide from a Candida Fink, MD's blog article at

Atypical Antipsychotics

Almost all of the atypical antipsychotics are notorious for causing fairly significant weight gain in most (but not all) people who take them. Here’s the list of culprits ranked from most to least risk for causing weight gain:
  • High risk: Olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), aripiprazole (Abilify), and clozapin (Clozaril)
  • Little to no risk: Ziprasidone (Geodon) and older first-generation antipsychotics such as perphenazine (Trilafon)
The weight gain from antipsychotics appears to come from increased appetite (“hyperphagia”) and some changes in metabolism. This family of medicines also has varying degrees of risk of certain health risks such as diabetes and elevated cholesterol, which may be related to the medication’s effect on metabolism.

Antidepressants and Antianxiety Medications
Antidepressants and antianxiety medications all have some risk of weight gain, although not typically in the same severe range as the antipsychotics. The risk seems to be more individualized – some people notice a lot of change in appetite and weight and some notice little. Occasionally, some people actually lose weight on these meds. In addition, these medications do not carry specifically the risks of diabetes and high cholesterol.
The most common antidepressants and antianxiety medications are the SSRI’s and SNRI’s (the weight gain risk really depends on the individual):
  • SSRI’s: Fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa) are some examples.
  • SNRI’s: Venlafaxine (Effexor) and Duloxetine (Cymbalta) are the most common.
Bupropion (Wellbutrin), which is in a class of its own, is the only antidepressant without any risk of weight gain – but it is not particularly effective for anxiety.

Anti-Manics or “Mood Stabilizers” and Anti-Seizure Medications

Mood stabilizers and the anti-seizure medications often used to treat or prevent mania may also carry the risk of causing weight gain, but the risk varies depending on the medication and its effect on the person taking it:

Curbing Weight Gain via Medication

When medication triggers weight gain, one of the more obvious solutions is through medications – either selecting a different medication that’s less likely to cause weight gain or adding a medication that has a track record for negating the weight-gain side effect.

The most important factor here is good communication with your prescriber and regular monitoring of the medications and their effects – both good and bad. Some weight gain may be unavoidable, but try to be honest with your doctor about what you will and will not live with in this department.


  1. Hello, I always like to read about Health tips.

    I lost approx 100 Pounds weight.

    It was my biggest dream which was come true by California medical weight management.

    I had tried many things, like control on diets, workout at home, weight loss pills and many other things, but nothing helped me. I had lost lot of money.

    One day I got an offer for free medical weight loss checkup and 40% discount on Program. I went for free consultation. They ensured me that I would lose my weight, they shown me previous results, their techniques and programs. I was impressed and enrolled in the program. Within a month, I lost 25 Pounds. I was so happy. In another 4 months I lost 100 pounds.

    My all friends were surprised, that was amazing...
    I am thankful of Dr. Michael.

    Friends, if you want to lose weight, I suggest you to talk with the doctor, they offer free weight loss consultation, to contact them, you just need to make appointment online and they will call you for free advice. Best of luck....

  2. Very nice!! there is so much information on this blog keep posting good information.
    learn How to Lose Weight Fast & Easy. For safe, natural & effective Weight Loss Tips & Self Hypnosis, make use of Fat Absorb to Burn Fat Fast as well as burning your calories down.

  3. Whose goal is to lose weight or stop gaining weight stay focused on balance! Also make sure you get at least 30 minutes of aerobic exercise daily. Incorporate stress management techniques like yoga or meditation into your daily routine. Maintain hormone balance with natural bio-identical plant based hormones and take a good quality nutritional supplement & drink lots of water. Even if you don't start losing weight immediately, you can at least correct the biological issues at play and put a stop to that unwanted weight gain once and for all.
    Physical Therapy Supplies