I checked my weight today and I have gained 20 lbs since being on clozapine and stopping the topamax (which counteracted the weight gain as it has weight loss as a side effect).
I'm always hungry because of this med and although I do exercise I can't stop gaining weight. It's frustrating. I need to buy a bunch of new clothes too because I'm too ******* fat for my old clothes.

[BeyondtheRainbow]

I've managed to lose some of the clozapine weight and stop gaining it by taking metformin. I could have lost more if my doctor weren't concerned my blood sugar would go too low on a higher dose.

It's really frustrating. Most of the clozapine weight has been in my belly and nothing seems to change that my clothes from a year ago don't fit.

I am not even all that hungry. I think Seroquel weigh gain was easier for me because I did get hungry at night on it. With this I'm not nearly as hungry but I still gained weight (and would gain more without metformin).

But for me I'd rather have the annoying weight gain than not have clozapine.

[Moose72]

Count me in. All my psych meds induce weight gain. And it's not just eating more. They screw up your metabolism!

[wildflowerchild25]

I know the feeling. I gained 70 pounds in a YEAR from high prolactin from invega. Had to buy new clothes three times. In January I started low carb and I've lost 12 pounds so it's slowly working. But I have to stick to it! Binged on pizza and candy yesterday. Starting over today.

It sucks that we have to choose between our mental health or physical health so often.

[franz kafka]

I gained 20lbs on Seroquel... still mad about that.

[HALLIEBETH87]

I've gained so much weight in the last ten years from psych meds and depression.

I'm 246 pounds. Fat ***

[chasse]

It is unfortnately a unwanted effect of taking psych meds. i gained so much weight when I was on valproate. Thankfully it didnt work and i am now on lithium. Seroquel makes people gain a lot of weight.

Weight gain is a really unwanted side effect but I would rather be well and not in hospital constantly than not be on meds. It is difficult to lose weight on certain meds. it is slow and hard but it is not impossible.

[Moose72]

Originally Posted by HALLIEBETH87

I've gained so much weight in the last ten years from psych meds and depression.

I'm 246 pounds. Fat ***

What's worse is when you see a new Dr all they want to talk about is your weight.

[BeyondtheRainbow]

Originally Posted by Moose72

What's worse is when you see a new Dr all they want to talk about is your weight.

When I was newly on meds I used to go in every time and say "I don't want to know my weight. Please don't tell me; I'll be closing my eyes. I don't want to talk about it; the gain is from my meds and I'm aware of it and the repercussions.". My family dr. has never bothered me about it because we had that discussion and it worked while I was in my years of different-every-time-gyn. So I never have to hear about it. I do get a suggestion of exercise but that's a check-off on the Medicare annual appointment thing.

[Sad Mermaid]

I gained weight in the past on Depakote (valproate), Zyprexa and Amitriptyline. Probably on others, too (Lithium, Seroquel, and Risperdal), but not a lot - this "trio" was the culprit for my gaining close to 100 lbs. I did not weigh myself when I was at the ideal weight so I do not have an exact number of the gain.

I weigh about 229 pounds being a 5'5'' woman. This is down from my worst weight, which was 238 - I was able to reduce the weight a little bit (and luckily noticeably in the belly area) by exercise alone last year. I then had a leg injury from wearing wrong shoes and did not exercise for several month. I have just been released to all exercise and cannot wait to see if I can reduce weight further.

Clozapine is notorious for weight gain and other metabolic side effects, but it is also more effective than other AP's, per my IOP psychiatrist. I can see how it would be a very tough choice to make, but also can definitely see how the circumstances may make clozapine non-negotiable.

I took a low dose of Zyprexa (again - last time I was on it several years ago) for a month and a bit recently and managed NOT to gain weight, by being very careful, but... my cholesterol still went up, so I went off it and am keeping it in my stash as a PRN. FWIW, this is what apparently helped me NOT to gain weight on Zyprexa this time, as this may help you in your very difficult situation:

1) drink 16-20 cups of fluid daily (for me, it is mainly black and fruit tea)
2) eat a whole artichoke with mayonnaise every other day (it takes very long and you get tired of the process of eating by the end)
3) eat soup daily
4) eat butter, sour cream and drink half-and-half in order to get full more quickly - avoid being completely low fat
5) reduce refined carbs
6) plenty of vegetables, fruits, whole grains, and legumes (this one is obvious, but I thought I'd still mention it)

I think the very key part is drinking 16-20 cups of liquid each day. That really keeps you full. If I have eaten my meal, and I use measuring cups for portion sizes, and am still feeling hungry, I make tea. By the time the tea has cooled off, I drink it and feel hunger no more. So to the extent that I can make sense of it, the most important part is consuming as high a volume of fluids as possible. Note that this level of fluid consumption is NOT pleasant - say, in the morning I drink two cups of weak coffee with half-and-half for pleasure, eat breakfast, wait 15 minutes, and then drink a whole pot of tea - 4 cups. Drinking the tea is NOT pleasant - my tummy is full and if not for the preventative benefits, I would not drink it, but it helps me avoid migraines and, as I also noticed, keeps me feeling full.

[BeyondtheRainbow]

The thing about clozapine is that by the time it is coming up as an option, especially in the US, there is generally nothing left to try. So the weight gain is the trade-off for feeling better. In my case it works so I deal with the weight the best I can. I will say that it is not a matter of working hard at losing as someone said above, clozapine just shifts metabolism so that it is a huge problem. I've worked hard and lost a lot of weight (40 lbs?) on Seroquel but Clozapine is different. Because it's rarely used people don't know that it is actually more likely to cause significant weight gain than Zyprexa, which is well-known for weight gain.

Personally I'm happy keeping my weight stable for now and keep remembering that at least I am not where I was a year ago (IP and extremely ill).

[Sad Mermaid]

I would say on Clozapine weight stability means success.

I did not know it is worse than Zyprexa. It was presented to me as equal to Zyprexa in metabolic side effects. By the way, hard as I tried at not gaining weight on Zyprexa (I succeeded), I still experienced a rise in cholesterol, because, as you said, it shifts your metabolism. I have the luxury of using Zyprexa as PRN only, so I will go that route. My understanding is that Clozapine cannot be used PRN, but only as a maintenance medicine.

[Moose72]

I'm on Zyprexa and Rexulti at the same time while I switch full time onto Rexulti. I hope Rexulti doesn't raise my cholesterol. (Zyprexa raised it to over 700!) My Pdoc said this was going to be better.

[BeyondtheRainbow]

Yeah, clozaril has to be used consistently or you have to go back through the gradual dose increases all over again. And missing a dose is very bad. I missed a dose one night and half a dose the next when my cat was so sick last week and was sick for 2 days as a consequence.

But I don't want to scare anyone off. With meformin my weight is about the same as it was when I started it a year ago today. The weight is distributed differently but I'm also menopausal which is another annoyance. I hate the weight issues and really wish I could take more metformin or more topamax but I can't.

And the thing is the med WORKS. I've never done so well so long. I probably had 8 months of relative stability (stable for me we say) and I'm depressed now but I've had to put both my cats to sleep in the last 2 months so there is a reason. Even then the depression sucks but I have lots of room to adjust the clozaril to help it and the clozaril will stop it. I've never really had a med that I could have that kind of confidence in. So it is totally worth it.

Metformin for me too. Before the Metformin I was rapidly gaining weight. I am losing it now, albeit slowly, but losing it all the same.

[Moose72]

I should ask to go back on metformin

[BeyondtheRainbow]

How much Metformin are you taking Justafriend? I'm stuck at 500 mg of the XR. I can go to 1000 if I do blood sugar tests and know my dr doesn't really recommend it; I decided to give 500 longer to work first.

1000mg twice daily for 2000mg. I was put on it when I was last hospitalized and they did in fact check my blood sugars daily. While I don't have a meter, I am supposed to make myself aware of if it drops too low.

[BeyondtheRainbow]

My doctor is worried b/c my last fasting blood sugar (off metformin) was 99. But I think that it was more like 13-14 hours after I ate so it was lower than it really was. I didn't have any problems with low blood sugar when I started, except after I gave blood and probably didn't eat enough afterwards. I'll ask for a fasting lab sometime and get it done accurately and see what happens.

I agree with the statement many of you are saying that the weight gain is worth the stability. I have had very minimal psychotic symptoms since starting it and have mostly stayed out of the hospital as long as I keep taking it.
I used to be on zyprexa and was able to keep the weight off, not so much with clozapine (or seroquel when I was on it fwiw)

[b1ghr0ll3r]

I've put on almost 20kgs since June-July & I noticed that was when I had an increase in seroquel & added Valproate. I managed to lose 4 or so KGs hen I was last in hospital but I put it back on not long after coming out, plus another 3kgs... I haven't exactly tried to lose the weight even though I really want to. I guess I need to commit myself to losing it before I can say whether it's going to be hard to lose

[Musician1980]

Originally Posted by Moose72

I'm on Zyprexa and Rexulti at the same time while I switch full time onto Rexulti. I hope Rexulti doesn't raise my cholesterol. (Zyprexa raised it to over 700!) My Pdoc said this was going to be better.

I had no issues with weight for the 4-5 weeks I was on Rexulti. I gained 12 pounds in 7 weeks on Abilify but on Rexulti, I lost 2 pounds.

[Moose72]

Originally Posted by Musician1980

I had no issues with weight for the 4-5 weeks I was on Rexulti. I gained 12 pounds in 7 weeks on Abilify but on Rexulti, I lost 2 pounds.

Why did you quit Rexulti?

[raspberrytorte]

I gained fifteen on seroquel, about fifteen on trileptal. Yes, trileptal made me gain weight! I lost it rapidly when I went off.

[HolisticGal]

I have gained a huge belly from nuerontin.