Recommend metformin 250 mg 3 times a day, along with lifestyle modifications, to promote weight loss and decrease insulin resistance in patients who gain more than 10% of their pretreatment body weight on antipsychotic medications.
Metformin has the most evidence of efficacy, while topiramate, sibutramine, aripiprazole and reboxetine are also effective. These drugs prevent or treat weight gain through different mechanisms.
Physical activity, in particular, can have a double effect of both improving mental health and minimizing weight gain that might otherwise occur. Cognitive and behavioral strategies under the guidance of a psychologist may be useful for avoiding giving in to any increased cravings for sweets and carbohydrates.
Antipsychotic-induced weight gain and metabolic effects show diurnal dependence and are reversible with time restricted feeding.
The average weight gain from these medications–including asenapine, iloperidone, paliperidone LAI, quetiapine IR, and risperidone–ranged from three to nearly six pounds. Even at very low doses, quetiapine was associated with significant metabolic alterations, they found.
Weight Loss Interventions for Those Taking Psychotropic Medications. Some of these interventions included engaging in physical activity, obtaining nutritional advice, participating in behavioral programs, and gaining access to free fruits and vegetables.
Many factors can affect this energy balance and lead to weight gain. The main way that antipsychotics cause weight gain is by stimulating appetite so that people feel hungry, eat more food and take in more calories. Some people taking antipsychotics report craving sweet or fatty food.
Some antipsychotics, such as aripiprazole (Abilify) and ziprasidone (Geodon), have a lower risk for weight gain. Discuss the risk of weight gain from antipsychotics with your healthcare provider.
Some weight gain may be inevitable when taking medications for bipolar disorder. If weight gain is an issue, ask your psychiatric care professional for advice on strategies to manage it. Healthy eating, keeping physically active and getting psychological counseling (psychotherapy) can all help.
Antipsychotic drugs, scientists showed, not only block dopamine signaling in the brain but also in the pancreas, leading to uncontrolled production of blood glucose-regulating hormones and, eventually, obesity and diabetes.
Weight gain is possible with many medications. Some examples of medications that can lead to weight gain include: Antipsychotics: such as aripiprazole (Abilify), chlorpromazine (Thorazine), clozapine (Clozaril), olanzapine (Zyprexa), pimozide (Orap), quetiapine (Seroquel), risperidone (Risperdal), ziprasidone (Geodon)
Psychotropics with the greatest propensity to cause weight gain include various antidepressants (eg, amitriptyline, mirtazapine), antipsychotics (eg, olanzapine, clozapine), and mood stabilizers (eg, lithium, valproate).
It should be noted that not all psychotropic drugs lead to weight-gain, and some have even been shown to decrease weight, such as serotonin-reuptake inhibitors (SSRI) during the first few weeks of use (Michelson et al.
Abilify (aripiprazole) is an atypical antipsychotic that can cause weight gain. But the chance of weight gain seems to be less than that of other atypical antipsychotics. You can help prevent weight gain from Abilify by making healthy lifestyle choices, such as exercising regularly and eating a healthy diet.
“There are ways to control the antipsychotic induced weight gain by Abilify: portion control, maintaining a regular exercise routine, reducing the dosage, keeping track of your weight, and talking to your doctor about medications that may help.”
Clozapine, which has the strongest antipsychotic effect, can cause neutropenia.
Clozapine and olanzapine have the most weight inducing potential. Even ziprasidone, which is considered to be weight neutral, and aripiprazole a dopamine modulator produce weight gain in some.
Clozapine and olanzapine were shown to have the worst side effect profiles, but the research also demonstrated that a high level of metabolic side effects was linked to an improvement in the symptoms of schizophrenia.
Abilify may increase your appetite or cravings
No matter what they eat, they never feel satisfied and end up craving something else, usually carbohydrates or sugar. For some, the appetite increase is slight, for others it is significant. Increasing how much food you eat each day will cause you to gain weight.
To manage Seroquel and weight gain, the user should maintain regular exercise, preferably more than their normal routine, as antipsychotics slow the body's metabolism. Also, patients should find cheap and healthy alternatives for fast food. Fast food is the quickest and most affordable way to satisfy calorie cravings.
Your doctor might also prescribe a medication like metformin to help with weight loss. You can also ask your doctor if you can switch to a drug with lower risk of weight gain. Any weight you gain usually goes away when you stop taking antipsychotics.
Phentermine is for people with obesity or overweight who haven't been able to lose enough weight with diet and exercise alone to improve their health. Phentermine is a Schedule 4 drug. This is a label given to drugs that can be misused.
The longer you have been taking a drug for, the longer it is likely to take you to safely come off it. Avoid stopping suddenly, if possible. If you come off too quickly you are much more likely to have a relapse of your psychotic symptoms. It may also increase your risk of developing tardive psychosis.