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Daniel K. Hall-Flavin, M.D.
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Daniel K. Hall-Flavin, M.D.
Daniel K. Hall-Flavin, M.D.
Dr. Daniel Hall-Flavin, board certified in general psychiatry and addiction psychiatry, is a St. Louis native looking to the Internet as a way to help people improve their health and be more active participants in their own health care by learning from Mayo Clinic's experts.
Dr. Hall-Flavin served on the faculties of Cornell University Medical College, New York Medical College and The George Washington University Medical School before joining the Mayo Clinic staff in 1996. He has special interests in adult psychiatry, addiction psychiatry, pharmacogenetics and personalized medicine. He served as medical director of the National Council on Alcoholism and Drug Dependence from 1986 to 1999, and is currently involved in translational medicine research involving the introduction of pharmacogenetic technology into the daily practice of community psychiatry.
"With the advent of pharmacogenetics and related fields and the advances in translational medicine, informed collaborative relationships between knowledgeable, capable health professionals and informed, proactive individuals and their families are more vital than ever," he said.
"I'm optimistic that our Internet health education activities will contribute to ever-improving health outcomes for all who participate and apply what is learned."
Tests and diagnosis (1)
- Bipolar disorder in children: Is it possible?
Complications (1)
- Bipolar disorder and alcoholism: Are they related?
Treatments and drugs (2)
- Bipolar medications and weight gain
- Bipolar treatment: Are bipolar I and bipolar II treated differently?
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Question
Bipolar medications and weight gain
Do all bipolar medications cause weight gain?
Answer
from Daniel K. Hall-Flavin, M.D.
Bipolar disorder is usually treated with a number of medications. These can include mood-stabilizing medications, antidepressants and antipsychotics. A number of these medications can increase your appetite and cause changes in metabolism leading to weight gain.
- Mood-stabilizing medications used to treat bipolar disorder include lithium (Eskalith, others), valproic acid (Depakene), divalproex sodium (Depakote), lamotrigine (Lamictal) and asenapine (Saphris). All of these medications are known to cause weight gain except lamotrigine. Asenapine doesn't appear to cause weight gain, but more studies are needed to be certain of its possible side effects.
- Antipsychotics commonly prescribed for bipolar disorder include olanzapine (Zyprexa), risperidone (Risperdal), ziprasidone (Geodon) and quetiapine (Seroquel). These medications are also used to treat schizophrenia. They can cause weight gain when taken alone, but weight gain appears to be more significant when an antipsychotic is combined with a mood stabilizer. Weight gain in children taking antipsychotics is particularly concerning — kids can quickly gain a lot of weight on these medications.
- Antidepressants can cause weight gain in some people. Newer, commonly prescribed antidepressants such as selective serotonin reuptake inhibitors (SSRIs) don't generally cause weight gain. However, reactions to these medications vary from person to person. Paroxetine (Paxil) and mirtazapine (Remeron) may be more likely to cause weight gain than other commonly prescribed antidepressants. Weight gain is most likely to be a problem with certain older, less commonly prescribed antidepressants, which include tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs).
In addition to causing weight gain, some mood stabilizers and antipsychotics may increase your risk of diabetes, heart disease and other health problems. For this reason, your doctor may recommend regular blood tests to check your blood sugar and cholesterol when you take these medications.
The likelihood that a certain medication will cause weight gain or other side effects varies from person to person. Likewise, how well the medication works to treat bipolar disorder symptoms is different for each individual. Because of this, finding a medication or combination of medications to treat your symptoms may require some trial and error. In some cases, medications that cause weight gain may be needed only temporarily to get your symptoms under control. Then, you and your doctor can find long-term treatment (maintenance treatment) that keeps symptoms at bay and causes the least side effects.
Some weight gain may be inevitable when taking medications needed to control your symptoms. However, strategies such as healthy eating, regular exercise and psychological counseling (psychotherapy) can all help. Be patient and keep working with your doctor to find the best way to keep your symptoms — and your weight — under control.
Next questionBipolar treatment: Are bipolar I and bipolar II treated differently?
- Correll CU. Weight gain and metabolic effects of mood stabilizers and antipsychotics in pediatric bipolar disorder: A systematic review and pooled analysis of short-term trials. Journal of the American Academy of Child and Adolescent Psychiatry. 2007;46:687.
- Torrent C, et al. Weight gain in bipolar disorder: Pharmacological treatment as a contributing factor. Acta Psychiatrica Scandinavica. 2008;118:4.
- Bishara D, et al. Asenapine monotherapy in the acute treatment of both schizophrenia and bipolar I disorder. Neuropsychiatric Disease and Treatment. 2009;5:283.
- Martinez M, et al. Psychopharmacology. In: Hales RE. Textbook of Psychiatry. Arlington, Va.: American Psychiatric Publishing; 2008. http://www.psychiatryonline.com/content.aspx?aID=320111. Accessed Nov. 19, 2009.
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