[thickntired]

I have just started seeing a new pdoc. When I was diagnosed bipolar I was at a healthy BMI. After gaining weight on Abilify, risperdol, Seroquel and thorazine now 7 years later I am obese. During this time I was also exercising and following a healthy diet.

I am taking Lamictal and Tropamax as a mood stabilizer and very slowly losing some weight. I am not supposed to carry over 20lbs because I have 3 ruptured discs, but I'm carrying and extra 70lbs in body weight. I told my pdoc that I am in constant pain and unable to take more than aleve and muscle relaxers because I have a history of addiction. My back and spine are compromised and unable to carry this much weight. Walking and Pilates for weight loss is painful, but I have to do whatever it takes so I don't live in constant pain.

This new pdoc just told me flat out that all AP cause weight gain, and I have to be taking one. In my opinion giving an obese patient a pill that causes more weight gain or an inability to lose weight is highly unethical. She also knows that I have just started estrogen for menopause which means an added weight gain every year for the next 5 to 10 years. I am so sick and tired of all these pdocs ignoring health risks in the name of mental stability. Why don't I have a say in what I am uncomfortable putting into my body everyday? Why won't she respect the fact that my fear of diabetes, stroke, heart disease, tardive dyskinesia and brain atrophy outweigh my fear of psychosis?? The mental health professionals I've met act like my issue with obesity is a matter of vanity. I would like them to walk in my shoes for a week. They can be nagged by their family or spouse, stigmatized by society and drop their self-esteem in the toilet. It's so easy for all of these freaking mental health workers to tell me what to do because NONE of them have a weight problem. Then when I tell my MD that I'm exercising and eating a healthy diet he looks at me like I'm full of crap.

[ChangingMyMind]

I am with you! Mostly anyway. I also started pills to help with MI at a fairly normal weight and ended up obese in a very short time, added a total of 80 lbs to my 5'3" frame. I was not told about this possibly at all but since I have depression and anxiety I was told I would have to be on meds forever. While I haven't been on APs only ADs I do understand because I always have the nasty weight gain side effect. Can't take the ones that are weight neutral like Wellbutrin due to allergies. The only time I was able to take weight off while on an AD was with a stimulant added, but they only prescribed that because I couldn't stay awake due to the hypersomnia that the AD caused.

It's frustrating but the reality of my situation is I have to have some sort of treatment beyond psychotherapy. My depression and anxiety are too debilitating to manage otherwise. So in my case I choose not to go without treatment. Although, I've never met a doc that told me I could not go off medicine. They're always ok with trying it out.

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[Can't Stop Crying]

I absolutely understand where you are coming from. It is because of side effects (including weight gain) that I stopped seeing psychiatrists all together and now get my meds through my primary care doctor (I am fortunate to have found a GP that specializes in psychopharmocology)
I was tired of pdocs arrogance in their attitude towards me and their complete disregard for my input on what meds I should/should not be taking
My current MD (I have been seeing him for more than a decade) has literally saved my life when I was standing on the edge of a cliff. He is the only one I trust for my meds. Period.
It's horrible that some pdocs (note: they also have a MD) do not treat the whole person and are so focused on the right med for the right dx....not the right med for the individual.
Sorry - I did not mean to go off on a rant there. I understand your frustration completely.

[thickntired]

Originally Posted by ChangingMyMind

I am with you! Mostly anyway. I also started pills to help with MI at a fairly normal weight and ended up obese in a very short time, added a total of 80 lbs to my 5'3" frame. I was not told about this possibly at all but since I have depression and anxiety I was told I would have to be on meds forever. While I haven't been on APs only ADs I do understand because I always have the nasty weight gain side effect. Can't take the ones that are weight neutral like Wellbutrin due to allergies. The only time I was able to take weight off while on an AD was with a stimulant added, but they only prescribed that because I couldn't stay awake due to the hypersomnia that the AD caused.

It's frustrating but the reality of my situation is I have to have some sort of treatment beyond psychotherapy. My depression and anxiety are too debilitating to manage otherwise. So in my case I choose not to go without treatment. Although, I've never met a doc that told me I could not go off medicine. They're always ok with trying it out.

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So, you're unable to take Prozac? I didn't know that many AD caused weight gain We are the same height, so I'm sure you know where I'm coming from. My last stupid pdoc put me on amitriptyline which is like the only AD that causes weight gain in women only. It really sucks because for me anyway the obesity makes my depression and anxiety worse. I also was NEVER given any info about side effects. I think they know if they told us the side effects we would never take them. I took Adderall with AP but it really only helped for a year or two. I do believe that any med that causes sedation like your AD has a weight gain side effect.

[ChangingMyMind]

Originally Posted by thickntired

So, you're unable to take Prozac? I didn't know that many AD caused weight gain We are the same height, so I'm sure you know where I'm coming from. My last stupid pdoc put me on amitriptyline which is like the only AD that causes weight gain in women only. It really sucks because for me anyway the obesity makes my depression and anxiety worse. I also was NEVER given any info about side effects. I think they know if they told us the side effects we would never take them. I took Adderall with AP but it really only helped for a year or two. I do believe that any med that causes sedation like your AD has a weight gain side effect.

No unfortunately I can't take Prozac either I get itching/rash with it. The only meds I was able to tolerate were Celexa (gained the 80lbs), Lexapro (on for a short time and was soo hungry all of the time I would have gained quite a bit had I stayed on it, and Cymbalta... Not sure if the Cymbalta caused weight gain or not was only on it 3 months before depression came back.

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[thickntired]

Originally Posted by Can't Stop Crying

I absolutely understand where you are coming from. It is because of side effects (including weight gain) that I stopped seeing psychiatrists all together and now get my meds through my primary care doctor (I am fortunate to have found a GP that specializes in psychopharmocology)
I was tired of pdocs arrogance in their attitude towards me and their complete disregard for my input on what meds I should/should not be taking
My current MD (I have been seeing him for more than a decade) has literally saved my life when I was standing on the edge of a cliff. He is the only one I trust for my meds. Period.
It's horrible that some pdocs (note: they also have a MD) do not treat the whole person and are so focused on the right med for the right dx....not the right med for the individual.
Sorry - I did not mean to go off on a rant there. I understand your frustration completely.

The best MD I ever had also had a pharmaceutical degree (not sure if that is worded correctly). I could not agree with more about the audacity and clash of egos when a MD and pdoc butt heads. Also, like you said they all went to medical school but for some reason that information is thrown out the window by pdocs. Just because I have mental illnesses doesn't mean I don't have a brain but that's how I've been treated. There is a huge misconception that people go off there meds because they enjoy mania or suffer from paranoid delusions and believe the medication is poisons. My manic episodes are horrific, but I get them a few times a year with or without the medication. I know this because I was misdiagnosed for so many years and only on Prozac.
So, why would I want to take a harmful medication every single day of my life when in reality it doesn't prevent mania or psychosis. As a recovering addict, I didn't get sober to take pills that have even scarier side effects. The scariest thing I read in the Journal of Medicine is that due to the obesity epidemic and health costs of diabetes pdocs now are expected to "educate" patients taking AP about diet and exercise. They went on to blame excess weight on a combination on medication, sedentary lifestyle, and unhealthy diet. That makes me furious. I nearly killed myself walking 25+ miles a week, Pilates, free weights, and a healthy diet (no starving). After doing this for a couple years I gained until my weight plateaued at over 200lbs. I have never in my life seen a number like that on the scale. I am on ssdi so I plan to let this pdoc write a script for some cheap generic AP that I'm not going to take. I can't afford to be non-compliant. Thank you very much for your reply.

[archipelago]

I get your frustration and outrage. I was healthy, muscular, and trim before I started seeing a psychiatrist. I ballooned out very quickly on the meds he prescribed even though I had depression and PTSD so didn't really need AAP's.

Fastforward to years later. I no longer take those meds, I eat lower than I should, and exercise, yet I'm overweight to the point that my blood sugar is high. I have to lose the weight or I will develop diabetes which is another side effect.

Not only is it horrible to gain all that weight so fast but then not to be able to lose it even if off the meds.

[~Christina]

I understand your frustration ... I really do ..

There are a few AP's that are considered weight neutral .. but there is always going to be some people that do infact gain weight.. no way around that honestly..

My Questions for you are ...

Can you find a new Pdoc that will actually listen and come up with a treatment plan you can live with?

If your going manic a few times a year whether your on meds or not then what is the point of daily AP's if your still having episodes ? I refuse daily AP's and only take them if I need them for a few weeks to level out a manic episode.. My Pdoc is perfectly happy with this plan, we both agreed there is no reason to stay on heavy duty chemicals daily.

I hope your able to find a caring Doctor that actually listens

I've gained weight from almost every p-med I've been on. It is of concern to me, but the p-docs don't seem to pay any mind to the weight gain. For the life of me, I cannot understand why p-meds that don't cause weight gain haven't been invented. It seems somewhat unethical to me, too, to prescribe medication that is known to compromise a patient's health.

[thickntired]

Originally Posted by ~Christina

I understand your frustration ... I really do ..

There are a few AP's that are considered weight neutral .. but there is always going to be some people that do infact gain weight.. no way around that honestly..

My Questions for you are ...

Can you find a new Pdoc that will actually listen and come up with a treatment plan you can live with?

If your going manic a few times a year whether your on meds or not then what is the point of daily AP's if your still having episodes ? I refuse daily AP's and only take them if I need them for a few weeks to level out a manic episode.. My Pdoc is perfectly happy with this plan, we both agreed there is no reason to stay on heavy duty chemicals daily.

I hope your able to find a caring Doctor that actually listens

Hi Christina,

Thank you for your reply. There is a huge shortage of pdocs here. I just got away from a horrible one after being on a waiting list for 4 months! I can't afford to be considered "non-compliant" and seeing a MD only is hard with ssdi paperwork. I told my new pdoc that I was comfortable and doing fine on a mood stabilizer alone. She said yes but that's now and you will need an AP when you go psychotic. Then what really blows my mind is she asked if I have the mental cognition to stop my SSRI when I'm hypomanic or full blown manic!! So, to your point why would I take it everyday when I can take it PRN??

[thickntired]

Originally Posted by ChangingMyMind

No unfortunately I can't take Prozac either I get itching/rash with it. The only meds I was able to tolerate were Celexa (gained the 80lbs), Lexapro (on for a short time and was soo hungry all of the time I would have gained quite a bit had I stayed on it, and Cymbalta... Not sure if the Cymbalta caused weight gain or not was only on it 3 months before depression came back.

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Really?! Wow, I didn't know that AD could be so hard to mix and match. That sucks about Lexapro. My pdoc just put me on it, but I read it usually causes weight loss. I knew a man who was given Prozac to help with his obesity. There are so many AD, but I understand that it is very weary changing meds and feeling like crap half the time!

Take Care

[Altered Moment]

I didn't read all the follow posts but I think you do have a say in your treatment. My pdoc lets me choose what I want to try or he makes a suggestion.

Why do you have to be on an AP for bi polar? Do the mood stabilizers not work?

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[thickntired]

Originally Posted by archipelago

I get your frustration and outrage. I was healthy, muscular, and trim before I started seeing a psychiatrist. I ballooned out very quickly on the meds he prescribed even though I had depression and PTSD so didn't really need AAP's.

Fastforward to years later. I no longer take those meds, I eat lower than I should, and exercise, yet I'm overweight to the point that my blood sugar is high. I have to lose the weight or I will develop diabetes which is another side effect.

Not only is it horrible to gain all that weight so fast but then not to be able to lose it even if off the meds.

What an idiot giving you those strong meds for PTSD and depression!! I have both of those and they don't cause psychosis. I'm so sorry about your blood sugar I know that is scary. I have only had ONE pdoc ask for annual blood sugar testing while prescribing AP. They just don't give a crap about health. Maybe if you don't eat under your recommended allowance, but stay away from sweets the weight will come off faster?

I know exactly what you mean. It was like one day I woke up and NONE of my clothes fit. I shop at Goodwill now and only if I absolutely need something. I was always athletic running track, playing tennis and taking ballet. Even after my car accident I stayed active. You worded it correctly - I have ballooned!! My face is so puffy it is unrecognizable, and I have no neck - just chins. The weight is SO slow coming off especially because I'm in my forties and starting menopause. It took about 5 months to lose 20lbs and, that was because I stopped the Seroquel and took Topamax.

I would suggest that even though it's tempting don't starve yourself. I don't know what diet you have to follow to lower your blood sugar, but it's probably good to have the right vegetables and lean protein so your metabolism won't go into starvation mode.

Take Care

[Altered Moment]

I am 50 and 30 to 40 pounds over weight. My sugar levels are high but not pre diabetic. I would try an AAP if nothing else was working. If it made me gain weight no way I would take it. It would have to be weight neutral and not effect sugar. It will suck if I get to the point where nothing else works because how do you decide those trade offs.

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[thickntired]

Originally Posted by zinco14532323

I didn't read all the follow posts but I think you do have a say in your treatment. My pdoc lets me choose what I want to try or he makes a suggestion.

Why do you have to be on an AP for bi polar? Do the mood stabilizers not work?

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I go psychotic and delusional when I'm manic because I have Bipolar I. In Bipolar II there is no psychosis, delusions or hallucinations. But I don't know if this is true for every patient. I have NEVER been given a choice to not take an AP and I'm always opposed to taking one. Maybe by law a pdoc has to prescribe one because a psychotic person could be suicidal or homicidal? The mood stabilizers are fine and really on a daily basis I don't think about my bipolar. Many of my mental issues like anxiety or ptsd are more annoying.

[Altered Moment]

Maybe by law a pdoc has to prescribe one because a psychotic person could be suicidal or homicidal?

I don't think there is any such law unless you had court ordered treatment because of some criminal offense.

[archipelago]

Originally Posted by thickntired

What an idiot giving you those strong meds for PTSD and depression!! I have both of those and they don't cause psychosis. I'm so sorry about your blood sugar I know that is scary. I have only had ONE pdoc ask for annual blood sugar testing while prescribing AP. They just don't give a crap about health. Maybe if you don't eat under your recommended allowance, but stay away from sweets the weight will come off faster?

I know exactly what you mean. It was like one day I woke up and NONE of my clothes fit. I shop at Goodwill now and only if I absolutely need something. I was always athletic running track, playing tennis and taking ballet. Even after my car accident I stayed active. You worded it correctly - I have ballooned!! My face is so puffy it is unrecognizable, and I have no neck - just chins. The weight is SO slow coming off especially because I'm in my forties and starting menopause. It took about 5 months to lose 20lbs and, that was because I stopped the Seroquel and took Topamax.

I would suggest that even though it's tempting don't starve yourself. I don't know what diet you have to follow to lower your blood sugar, but it's probably good to have the right vegetables and lean protein so your metabolism won't go into starvation mode.

Take Care

Thanks so much. I really feel understood and supported. Sorry though that you have had the balloon/clothes search experience too.

You are right about not eating under too much. I was doing that for a while, not realizing how low I was, and I wasn't losing weight, but I did go into starvation mode and screwed up my metabolism. When I started to increase my calories, I actually started to lose weight without too much effort which was weird but nice.

I am also experiencing menopause so my body composition is different and I'm sure it will take longer for me to reach my goals. Still I do feel more hopeful than I have in years. I basically eat protein and veggies. I don't like sweets. And I've lowered my carbs. I'm starting an exercise routine that uses some light weights. Apparently short workouts with weights increase muscle mass and help boost metabolism and also help in age to restore lost muscle mass. So I'm going to balance that with cardio.

I think I'll be able to get my blood sugar down, though I do take Abilify as an anti-depressant augmentation so that makes me nervous. Perhaps I'll stop that since I am feeling less depressed.

[thickntired]

Originally Posted by archipelago

I am also experiencing menopause so my body composition is different and I'm sure it will take longer for me to reach my goals. Still I do feel more hopeful than I have in years. I basically eat protein and veggies. I don't like sweets. And I've lowered my carbs. I'm starting an exercise routine that uses some light weights. Apparently short workouts with weights increase muscle mass and help boost metabolism and also help in age to restore lost muscle mass. So I'm going to balance that with cardio.

I think I'll be able to get my blood sugar down, though I do take Abilify as an anti-depressant augmentation so that makes me nervous. Perhaps I'll stop that since I am feeling less depressed.

I'm so glad you are feeling hopeful I find that the more I eat whole, unprocessed carbs the less I want. For protein I like Greek yogurt, boiled eggs, and walnuts & avocado are supposed to be healthy fats. My Gyno said about 4lbs a year is average weight gain for menopause, and that may be in women who do not exercise or follow a healthy diet. You're absolutely correct about muscle & bone density. I take 1200mg of calcium a day and a low dose of estrogen to prevent osteoporosis. My Dr. told me that a lack of estrogen can cause bone damage. Pilates is really great strength training and develops the core muscles (abdominal) so there is not a lot of strain on the spine. Really it is a total body work out. I use a DVD and a mat to do it at home along with 25mi walks a week for cardio. You could probably find a free Pilates demo on Youtube to see if you like it. I took Abilify for about 4 years, and I did gain weight but very slowly over time. It was just too expensive AND be careful because it caused manic spending for me.

[ChangingMyMind]

Originally Posted by thickntired

Really?! Wow, I didn't know that AD could be so hard to mix and match. That sucks about Lexapro. My pdoc just put me on it, but I read it usually causes weight loss. I knew a man who was given Prozac to help with his obesity. There are so many AD, but I understand that it is very weary changing meds and feeling like crap half the time!

Take Care

Yeah it can be hard for some of us. I am very sensitive to medicine and have pretty bad anxiety so the mix of the two does not help matters. I am not on any meds now but I might have to get on another one in the future. I refuse to take APs because I don't need them, even if it helps with depression there are safer options. Not much safer lol but I'll take what I can get.

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[thickntired]

Originally Posted by ChangingMyMind

Yeah it can be hard for some of us. I am very sensitive to medicine and have pretty bad anxiety so the mix of the two does not help matters. I am not on any meds now but I might have to get on another one in the future. I refuse to take APs because I don't need them, even if it helps with depression there are safer options. Not much safer lol but I'll take what I can get.

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Oh my gosh yes!!! You don't want to be on an AP if it's not necessary. Anxiety is hard for me as well. Years ago I was on benzos like valium or xanax which are basically pointless. I built up a tolerance in a week, and if I had a panic attack hello?? The pill would kick in later. So, I'd freak out then be really sleepy lol. The thing with anxiety is the more I try not to make a big deal out of a stressful situation the more I end up making a big deal. And I'm so neurotic grocery shopping can be a big deal on some days. It made me mad because I've heard it all my life and thought it was new age nonsense but deep breathing really can help. The last time I was in patient my anxiety was so bad that my hear rate was at a crisis level. So, naturally that made me more anxious and I got stuck back in my cycle. This psych nurse grabbed me and yelled pay attention to your breathing. I actually have never stopped to do that. Anyway, I've been going through life taking quick shallow breaths all the time. I had just gotten used to that and it felt normal. So, I haven't fully embraced yoga or meditation yet but I try to be more aware.

[catman1975]

I hear you 100%. I was always after my psych doctor about my weight gain and ED problems, I knew the meds could be causing it. Wasn't until I ran out of money to fill the prescriptions that I realized how much they were affecting me. I blame the ED on the Prozac and the weight gain on the Risperdal. Both seem to be getting back in check now, and I wouldn't say I'm feeling 'good' from a mental health standpoint, but I am managing it. We will see how it goes.

[ChangingMyMind]

Originally Posted by thickntired

Oh my gosh yes!!! You don't want to be on an AP if it's not necessary. Anxiety is hard for me as well. Years ago I was on benzos like valium or xanax which are basically pointless. I built up a tolerance in a week, and if I had a panic attack hello?? The pill would kick in later. So, I'd freak out then be really sleepy lol. The thing with anxiety is the more I try not to make a big deal out of a stressful situation the more I end up making a big deal. And I'm so neurotic grocery shopping can be a big deal on some days. It made me mad because I've heard it all my life and thought it was new age nonsense but deep breathing really can help. The last time I was in patient my anxiety was so bad that my hear rate was at a crisis level. So, naturally that made me more anxious and I got stuck back in my cycle. This psych nurse grabbed me and yelled pay attention to your breathing. I actually have never stopped to do that. Anyway, I've been going through life taking quick shallow breaths all the time. I had just gotten used to that and it felt normal. So, I haven't fully embraced yoga or meditation yet but I try to be more aware.

Lol @ the benzos comment. I can see that happening to me. I also refuse benzos and any other anti-anxiety meds besides stuff like hydroxyzine because that's basically a antihistamine that just makes you sleepy, so you get the same effect as taking a benzo sounds like. It really doesn't do crap for my anxiety until I get sleepy then I'm too sleepy to worry anymore. But like you I'm already done with the anxiety attack... Lol its not funny what we go through but I have to make light of it, it makes it easier!

But yeah since I've been off the ADs I can eat like a normal person and not gain 6lbs in a day! It's a nice change. I can't really exercise right now for other reasons so I've been laying around the house watching TV a lot and still am not gaining weight. It's one good thing out of all ive been through this year.

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[-jimi-]

I see an issue where that has been ongoing the last 15 years. Bipolars don't seem to be stabilized anymore. In the old days many were on lithium which usually worked quite well, some don't tolerate it and some get toxic. But the main thing was still getting mood swings under control. These days they might instead add a few pretty weak epilepsy meds as stabilizers. Sometimes docs even think all in that class are equally strong when in fact some basically have almost no stabilizing effect at all.

Stronger stabilizers could be tegretol and depakote, weak ones topamax and neurontin. Even with the stronger you might have to be on more than one.

Doctors solve this these days by adding an antipsychotic med. For mood swings. But not really. For the effects of mood swings. Justified sometimes but IMO not always. Those meds come with quite harsh side effects, the newer ones they usually want to prescribe come with a strong disturbance in handling carb and sugar.

And yea they do hand them out like candy at times, I am not even bipolar and still tried two antipsychotics. (Because it was believed they would take away bad thoughts, fat chance they did that!) And now they prescribe them for sleep. I am somewhat worried.

Options... could be, try a stronger mood stabilizer... take AP as needed (if that would work)... or get on a AP diet (described by my old doc as quite close to Atkins, since even with the med, processing fat and protein is near normal, processing carb is VERY disturbed).

Wish you luck.

[archipelago]

My shrink said I should try Abilify as augmentation for depression. But I also just got a report that my blood sugar is too high. Doesn't that mean that I shouldn't get near something that might make my blood sugar even worse? And it lowers metabolism and increases hunger. Was I told this? No. Did he know about these concerns of mine before. Yes.

[-jimi-]

I feel like they are taking you apart and treat you piece by piece. I have many times told docs they cannot prescribe a certain med because it is a lupus trigger and I don't wanna die and they treat me like we prescribe the same stuff if you are healthy or not, deal with it. It's not so bad. And your other illness is not OUR problem!!!!