Rethinking Antipsychotics - Part II

By John McManamy, Health Guide Tuesday, September 04, 2007

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In an earlier blog I noted that there may be a sea change in how psychiatry thinks about prescribing new-generation (atypical) antipsychotics such as Zyprexa and Risperdal. Originally approved for treating schizophrenia, over the last several years the FDA has approved their use for treating sho...

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tabby

9/ 4/07 8:21am

I am a slightly overweight person to begin with. So, anything that will add 20-30 pounds on my frame would cause a obesity issue in regards to other health related problems (i.e., diabetes, blood pressure, heart, etc.).

I took Lithium, for example, and gained 20 pounds within the first 6 weeks. This was not due to overeating or reduction in exercise. This was cellular and systematic.

Yet, when I questioned this particular dramatic weight gain to my pdoc - the response was that the benefits outweigh the risks and which did I want, to feel better and balance my mood swings or to not gain any further weight? She thinking it was vanity questioning (which it wasn't). My family has a history of Diabetes, High Blood Pressure, Heart Disease.

I responded that I wanted both.

tabby

9/ 4/07 8:25am

As a foot note to my above response - after taking Lithium for quite a while and Lexapro and Klonopin - I gained in total 25 pounds within 2 of the 6 months I was on it and after 6 months - I didn't feel any better on any of the meds. In fact, I tried to od on tranquilizers. So, not only did I not feel better nor my mood swings balance but I gained a significant amount of weight in a relatively short period of time.

John McManamy, Health Guide

9/ 4/07 1:23pm

Hi, Tabby. Thanks for bringing this up. Any smart psychiatrist knows that serious side effects are not a justifiable trade-off for stabilizing your mood.

For one - you're gonna feel miserable physically and mentally hauling around extra weight and your self-esteem takes a big hit, which kinda defeats the whole purpose of taking an antidepressant or mood stabilizer or antipsychotic.

The American Psychiatric Association states that remission and full functioning are the goals of bipolar treatment. I interpret that as getting you to being chic, fabulous, and living well. If your pdoc is too stupid to figure that out then find one you can work with.

Again, thanks for posting this. I feel very strongly about this.

clydelady

9/18/07 10:35pm

A real bummer for me and the downward cycle starts.. Just to go in and for the doc to blow off my complaints or even request for something to help get me from the obese to just fat would be a step in the right direction.

No go. Reduction in calories is not always the answer either. sorry human bodies then go into starvation and stash every smidgin of fat they can grab because it is a survival technique.

there are meds out there that clearly help the weight issues, getting your regular doctor to not push off on the psych meds and getting your psych doctor to not blame your arthritis doctor is enough to push me on a bad day into an extremely frustrated grouchy bear.

Until doctors start to hear - that side effects or extreme weight gains are not acceptable tradeoffs for some less mania - then it is a long standing battle- not a partnership toward my overall wellness - You would think with the millions spent that the insurance industry would say hey ! don't add other health troubles to the psych ones. something like 3 out of 4 bipolar folks end up with blood, heart, insulin or other health issues directly related to weight gain from the psych meds. Bipolar sucks bad enough but fat and Bipolar are enough to make ya want to crawl in the bed and never come out.

Vicki

10/19/07 3:23pm

My son was put on Zyprexa at least 6 years ago at age 7. He actually benefited from the weight gain because he is tall and skinny, and the med worked to tame his rages until he hit puberty and his main problem became depression. Zyprexa exacerbated the depression and zonked him out so he was sleeping through classes in the morning. We took him off of it almost a year ago (age 14) and he's dropped a lot of weight (underweight at 6 feet tall and 125 lbs soaking wet), but he is so much more alert and functional (and has had much improvement in his mood). He is still on Depakote and Effexor. We won't use an antipsychotic again unless it's a crisis situation.

Rethinking Antipsychotics - Part II

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