Bipolar weight gain

I was diagnosed 3 years ago and after being on medication for awhile I gained 75 pounds.
I don't blame this all on the medication as not being able to work or even get out of bed some days is at least part of it. I also have PCOS (a condition that can make it easier to put on and harder to lose weight.)
I have in the last year managed to lose 25 of those pounds and maintain that weight.
Has anyone else experienced such significant weight gain? Are there any bipolar meds that DON'T cause weight gain? How do you try to stay healthy when you're depressed? Any insight would be very helpful.

MsSunflower, you are not alone. While stopping the meds was the only thing that worked for me, and even still the weight was very difficult to lose. Depression and sleep deprivation has me carrying the almost the same amount once again, years later. Now as of last week out of desperation I'm back on the same med that made me gain so much weight years ago. I'm floundering my way through it, and I have no advice at this point.

We are very much not alone, there a several threads on this topic, here are two of the most recent ones, they might offer some insight, or at least commiseration.

Physical Check-In

How does a bipolar person stay fit and thin?

Big Pharma screws up all of us when it comes to so many meds that causes often huge weight gain as if we don’t have enough to deal with.

There are numerous that are claimed to be weight neutral. Haldol is one , yes old school but actually decreased my appetite. Invega , Latuda to name a few. It’s often just a case of try xyz and seeing which is a good fit for you.

I have metabolic syndrome thanks to psych meds so it makes losing weight very difficult. I refuse to become diabetic and be more obese which will make my arthritis worse, so I’m making Med changes.

What meds are you currently on?

Although I'm sorry that you're struggling, it is nice to know it's not just me. Thanks very much for those links. I'm new here. I'll definitely check them out.

A lot of the literature I've read on medication says it isn't uncommon to gain 5lbs. I'm like '5lbs?! Try 50'. Glad to know it's not just me.
Of the meds you listed I've only tried Latuda but it didn't do anything for me. My PCOS also makes diabetes more likely but I have myself tested a couple of times a year and so far I've been okay. Was told awhile ago that my liver is a bit inflamed but my doctor is keeping an eye on that too.
I'm currently on Lithium and Seroquel (about 2 1/2 years). Then my doctor keeps trying various anti depressants/mood stabilizers. Taking Zoloft at the moment.

I hope you can find a combo that works for you psych wise and physically ok. It’s so hard to find.

MsSunflower, firstly, congratulations on your 25 lb weight loss! That's a big deal!

I can absolutely commiserate on frustrations with medication weight gain. However, I'm glad you also mentioned that depression and/or the change in lifestyle sometimes plays a part. So often people don't consider that fact. Some also ignore the fact that some weight gain is inevitable for many people who aren't on medications. I weighed more 17 years ago, before ever taking a single bipolar med, than I did for at least four of the years that I was taking bipolar medications.

I did experience some significant weight gain on certain bipolar medications, which combined with mood issues didn't help. I guess my biggest increase was 40 lbs. The bulk during a one-year period of severe mental struggle. Around 30 lbs of it. The other 10 came on gradually.

At my highest weight on meds (or ever), I insisted on a med overhaul. I also sought the help of a dietitian. My blood work was horrible (pre-diabetic, plus high cholesterol/triglycerides). The dietitian was a support and held me accountable. I lost 40 lbs in only six months with these two things and maintained most all of that loss for a good four years, until some less weight friendly med doses increased, and...life.

I can't unequivocally list weight neutral/friendly bipolar medications. I can only list the ones that were so for me. They include(d):

* Lithium ER - Yes, weight neutral for me. I lost the 40 lbs while on 900 mg.
* Trileptal (maintained weight)
* Tegretol XR (lost the 40 lbs on and maintained)
* Lamictal (lost the 40 lbs on and maintained)
* Abilify (lost some weight on)
* Geodon (lost the 40 lbs on and maintained)
* Navane (thiothixene), a 1st generation AP (maintained on)
* Ativan and Klonopin, benzos I take (maintained on)
* All of the antidepressants I ever tried, which made me hypomanic/manic
* Provigil, a stimulant, but made me manic
* Side effect meds like Cogentin, Synthroid, and Propranolol

There were other medications I tried that were not THAT weight unfriendly. Risperdal could have been worse. Seroquel XR (but not regular Seroquel) doses of 350 mg and below. Above 350 mg, not as much.

I was only on Neurontin (gabapentin) for a few days. Others say that is weight neutral. I've heard Topamax is usually quite weight friendly. Never tried it. I have also never tried Latuda, Saphris, Rexulti, or other newer antipsychotics.

The medications I gained weight on were Zyprexa, regular Seroquel, Seroquel XR doses above 350 mg, Risperdal (to a small degree), Depakote, Invega, and Trilafon (perphanazine - a 1st generation). I never tried any other 1st generation besides Trilafon and the one in my bullet list. Obviously, I had to stop some "weight friendly" meds for other reasons.

Sorry you are going through this. I know it's hard. I personally had to ditch the Seroquel. I gained roughly 75 pounds. And I have yet to lose it all. I try to at least get some walking in and do some stationary cycling. Any movement at all is better than none. hope you find what works! best of luck.

Some of the atypical antipsychotics are known for weight gain and frankly I get annoyed at how often they are handed out. Dont get me wrong, they are life savers for some people. Some people cant sleep w/o seroquel or risperdone but I cant say that I am on board with those being the first choices. In many cases the idea of mood stabilizers and antipsychotics are treated as one and the same. Yes Anti's help with mood but there are other specific mood stabilizers out there like lamicatal or lithium. I am BPII. I take cymbalta (an SNRI) buspar(anxiety) Lamictal (mood stabilizer) Latuda and geodon (anti's that help with my mood). I resisted geodon due to my bad experience with seroquel but after learning about it and talking with my doc I gave it a try. I was actually put on it while inpatient and it saved my life. I have found it to be weight neutral give or take the 10lbs I go up and down with. I know there are lawsuits out there for boys that have taken risperdol who had grown breasts- and for awhile they were putting kids on Anti's a lot. Most times a lower dose is more sedating and a higher dose can help with the mood issues. I know with Remeron a lower dose is better for sleep and higher better for depression. Same with seroquel. At 50mg-150mg doses its better for sleep at 250+ is better for mood. I dont know if that is true across the board. I think we as patients should not be afraid to discuss issues like diabetes, metabolic syndrome or weight gain with these drugs because they are not the only options.

Thanks everyone for sharing your experiences. I have suspected that the seroquel might be the cause of a lot of the weight gain. Unfortunately it is also the only medication that I can say with any certainty actually helps.