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Need Help with my weight gain
Hi,
I am on Divalproex (Desval ER 250) and I have put on weight. I do not know of any good docs in the city I am in and I am not in touch with my earlier doc. I just need advice here. Will this medicine keep making me put on weight on and on or is there any way I can curb this with diet and exercise. I have tried other drugs but I find this the best, except for the weight gain. What is the long term effect of this?
Also I take Desval along with Olanzapine 0.5 mg. Is this alright for my Bipolar disorder or should I add in an antidepressant. If yes, then which one? Coz Mood stabilizers I guess curb the thinking power, so will the anti depressant boost my thinking ability.
I am on Divalproex (Desval ER 250) and I have put on weight. I do not know of any good docs in the city I am in and I am not in touch with my earlier doc. I just need advice here. Will this medicine keep making me put on weight on and on or is there any way I can curb this with diet and exercise. I have tried other drugs but I find this the best, except for the weight gain. What is the long term effect of this?
Also I take Desval along with Olanzapine 0.5 mg. Is this alright for my Bipolar disorder or should I add in an antidepressant. If yes, then which one? Coz Mood stabilizers I guess curb the thinking power, so will the anti depressant boost my thinking ability.
What kind of a diet was it, and did you weigh yourself every day? Whether or not you've pooped recently can change your weight by at least a pound, and some scales are not super well calibrated. You might have actually just stayed the same weight. Exercise is also important (although it's really hard to actually do). Not only does it help with weight loss, there's also evidence that it helps with bipolar. If you do start exercising a bunch, keep an eye on body composition changes. Muscle weighs more than fat, so it's possible to stay the same weight or even gain a bit but be losing fat. Really muscled wrestlers can have BMIs of 30 when they have barely any body fat at all--it's all muscle. Don't use that as an excuse for weight gain or not losing, but be aware that it can happen (and you should be able to see it happen if it does).
Are you still on the olanzapine (if so, is it daily or just when needed)? Olanzapine is if anything a bigger weight gain culprit than valproate/divalproic acid. And I agree with Crystal, concentration and memory loss problems ARE problems, especially if it's the meds causing them. They can be symptoms of depression too, but if you aren't really depressed right now, chances are it's the meds and it's time to try a new one. Geodon is an atypical antipsychotic (same class as olanzapine) that's weight neutral. Lamictal is an anticonvulsant (like divalproex) that's weight neutral and especially good for bipolar depression. Trileptal is another anticonvulsant that I believe is weight neutral, and while bipolar is an off label use, a lot of people think it's a better version of Tegretol/Equetro (carbamazapine).
You should really talk to your psychiatrist about the weight gain and cognitive issues you're having, and ask about other options. Feel free to bring that list in as suggestions, but make them explain it to you if they don't like any particular choice.
Are you still on the olanzapine (if so, is it daily or just when needed)? Olanzapine is if anything a bigger weight gain culprit than valproate/divalproic acid. And I agree with Crystal, concentration and memory loss problems ARE problems, especially if it's the meds causing them. They can be symptoms of depression too, but if you aren't really depressed right now, chances are it's the meds and it's time to try a new one. Geodon is an atypical antipsychotic (same class as olanzapine) that's weight neutral. Lamictal is an anticonvulsant (like divalproex) that's weight neutral and especially good for bipolar depression. Trileptal is another anticonvulsant that I believe is weight neutral, and while bipolar is an off label use, a lot of people think it's a better version of Tegretol/Equetro (carbamazapine).
You should really talk to your psychiatrist about the weight gain and cognitive issues you're having, and ask about other options. Feel free to bring that list in as suggestions, but make them explain it to you if they don't like any particular choice.
You mentioned that you felt fine on divalprox. But you also mentioned that you couldn't concentrate much, forget things easily and have memory problems in addition to the weight gain. Just know there are other meds to choose from that don't, in my experience, cause all of these issues. I would talk to your psyc. Dr. About your concerns that you have mentioned to see if he can make some adjustments. In my past experience when taking a med that caused me to gain weight, I only let it get so high and then would decide it was time to try something else. Check into weight neutral meds. I take Lithium and Lamical with no weight gain. Keep in mind everyone is different. Some people will have side effects and or weight gain with a med and someone else on the same med may not. You just never know until you try. I would definitely try the diet and exercise together. If you can it's best to try one new med at a time. Then you know what the Side effects are. When you start 2 at the same time you don't know what is doing what as far as side effects go.
I went on a diet for 2 weeks and I'm still on Divalproex. I am NOT losing weight.If anything, I gained one kilo. I am really frustrated. What do I do? I am not going to change my medication coz it seems to work for me in other areas.
Well, in some cases, the mood stabilizers can benefit from a boost of antidepressant. Some mood stabilizers are better at preventing mania than they are at dealing with depression, so that would be one reason for the combo. Bipolar II tends to be mostly depression, and bipolar I can even be depression more often than mania. Lamictal is commonly a first choice in bipolar II because it seems to be good at dealing with the depression phase, and keeping it away for longer. Divalproex tends to be more anti-manic than anti-depressant.
I would be extremely careful with over the counter weight loss pills. A lot of them don't work (there's the small print about combining them with diet and exercise), and some of the ones that do can seriously interact with psych drugs (or other drugs). Heck, even the ones that don't work can have serious drug-drug interactions, and nasty side effects. If you do decide to try them, make sure to ask a pharmacist about interactions. I think you're much better off with diet and exercise.
Standard diet spiel: Cut out soda and juice (there's evidence that diet soda might increase your craving for sweet things, which is why I mostly stopped drinking it). Cut out carbs, especially sugar. Eat a broth-based soup or a salad (without high calorie dressing) before your main meal. I'll post more later if you want, but I have to run.
Hope this helped.
I would be extremely careful with over the counter weight loss pills. A lot of them don't work (there's the small print about combining them with diet and exercise), and some of the ones that do can seriously interact with psych drugs (or other drugs). Heck, even the ones that don't work can have serious drug-drug interactions, and nasty side effects. If you do decide to try them, make sure to ask a pharmacist about interactions. I think you're much better off with diet and exercise.
Standard diet spiel: Cut out soda and juice (there's evidence that diet soda might increase your craving for sweet things, which is why I mostly stopped drinking it). Cut out carbs, especially sugar. Eat a broth-based soup or a salad (without high calorie dressing) before your main meal. I'll post more later if you want, but I have to run.
Hope this helped.
I feel really fine with the Divalproex and have no issues as such except the weight gain. Do you think I should look for a weight loss pill in the market and have that?
Secondly, with the Divalproex, I can't seem to concentrate much, plus I forget things easily and have memory loss. As for my energy levels, it's great with this med. Why do docs prescribe an anti-depressant with a mood stabilizer for Bipolar?. Can't the mood stabilizer do the job?
Secondly, with the Divalproex, I can't seem to concentrate much, plus I forget things easily and have memory loss. As for my energy levels, it's great with this med. Why do docs prescribe an anti-depressant with a mood stabilizer for Bipolar?. Can't the mood stabilizer do the job?
You should really talk to a doctor about switching your meds. I can only give advice based on what I know as a private citizen without a medical license.
If you didn't like nexito because it made you too energized (in a good or bad way), I'm guessing SSRIs may not be the best choice for you. I have no idea if the weight gain from divalproex and/or olanzapine will level out or just keep going. Wellbutrin causes weight loss in some people, unlike a lot of psych meds. It can also cause constipation. It's generally energizing, so it might be good if you're feeling low on energy (make sure to take it in the morning). I'm on Wellbutrin and Lamictal, and they're working pretty well. My heart rate has definitely increased on the Wellbutrin, and I sometimes spike resting heart rates of 120, but that's not usual, and it's still better than being depressed. It also makes me burp, and gives me some constipation.
Constipation can be dealt with through diet or with fiber supplements (combined with plenty of water!), so if that's the only issue with a particular med, try working around it rather than quitting the med. I sometimes use the generic of benefiber, which really doesn't taste like anything or make things slimy.
Believe it or not, I'm actually pretty new to this game. I got my bipolar 2 diagnosis at the beginning of January, which is when I started the Wellbutrin and Lamictal. I took Prozac for a year starting in fall 2009 when I was diagnosed with depression. Other than that, I haven't taken any psych meds (I have Ambien and muscle relaxants, but they aren't for psych issues). How do I know so much then? I've done a metric **** ton of reading since then. Educating yourself about your condition and your options is an essential part of getting and staying better. It means you can work with your psychiatrist, instead of having to take them at their word (and even the best make mistakes).
I will do my best to answer any more questions you have, but keep in mind that I do have little personal experience with these drugs.
If you didn't like nexito because it made you too energized (in a good or bad way), I'm guessing SSRIs may not be the best choice for you. I have no idea if the weight gain from divalproex and/or olanzapine will level out or just keep going. Wellbutrin causes weight loss in some people, unlike a lot of psych meds. It can also cause constipation. It's generally energizing, so it might be good if you're feeling low on energy (make sure to take it in the morning). I'm on Wellbutrin and Lamictal, and they're working pretty well. My heart rate has definitely increased on the Wellbutrin, and I sometimes spike resting heart rates of 120, but that's not usual, and it's still better than being depressed. It also makes me burp, and gives me some constipation.
Constipation can be dealt with through diet or with fiber supplements (combined with plenty of water!), so if that's the only issue with a particular med, try working around it rather than quitting the med. I sometimes use the generic of benefiber, which really doesn't taste like anything or make things slimy.
Believe it or not, I'm actually pretty new to this game. I got my bipolar 2 diagnosis at the beginning of January, which is when I started the Wellbutrin and Lamictal. I took Prozac for a year starting in fall 2009 when I was diagnosed with depression. Other than that, I haven't taken any psych meds (I have Ambien and muscle relaxants, but they aren't for psych issues). How do I know so much then? I've done a metric **** ton of reading since then. Educating yourself about your condition and your options is an essential part of getting and staying better. It means you can work with your psychiatrist, instead of having to take them at their word (and even the best make mistakes).
I will do my best to answer any more questions you have, but keep in mind that I do have little personal experience with these drugs.
I checked up Nexito and it is basically Escitalopram which is an antidepressant. I don't wanna go back to that, and my earlier doc had prescribed that. Would you recommend me taking another antidepressant. If yes, which one? Otherwise, should I just stick to Divalproex and Olanzapine?
The other med used to take earlier with Divalproex was Nexito 20. But it results in constipation, so I stopped taking that and now just stick to the Divalproex and Olanzapine. What is Nexito anyway for? Is it an antidepressant?
I have another question(as I mentioned in my first post) - Will the weight gain stabilize after a point or will it keep going up and up and up?
Unfortunately, both divalproex and olanzapine can cause weight gain. Geodon (another atypical antipsychotic like olanzapine) and Abilify (a third generation antipsychotic) are supposed to be weight neutral, and may work well if olanzapine does. You need to talk to a doctor about switching, though.
Exercise and diet control are always good, and it won't hurt you to try using them to control the weight gain.
A lot of people recommend against antidepressants for bipolar, although it should be ok since you already have mood stabilizers on board. The worry is that antidepressants can send bipolar people manic, although this is far from a 100% thing. And antidepressants don't boost thinking ability, unless dulled thinking was caused by depression.
What other drugs have you tried? Lithium is rather unique, and other antiepileptic mood stabilizers (same class as divalproex) don't cause weight gain. A larger dose of an atypical antipsychotic might work for you, although most of them have a weight gain risk. CrazyMeds has extensive information on most drugs used in bipolar disorder, including the full prescribing information for doctors. If you're willing to slog through it, you can find out a lot about the risks and benefits of various drugs (they do have shorter summaries of the important points).
In the end, you're going to need a doctor to change any of your meds (and you shouldn't stop them either without a doctor's supervision). You could try a google search for psychiatrists in your area, and try to find customer reviews for them. I think most insurance companies have lists of in-network doctors that you can search through as well.
Exercise and diet control are always good, and it won't hurt you to try using them to control the weight gain.
A lot of people recommend against antidepressants for bipolar, although it should be ok since you already have mood stabilizers on board. The worry is that antidepressants can send bipolar people manic, although this is far from a 100% thing. And antidepressants don't boost thinking ability, unless dulled thinking was caused by depression.
What other drugs have you tried? Lithium is rather unique, and other antiepileptic mood stabilizers (same class as divalproex) don't cause weight gain. A larger dose of an atypical antipsychotic might work for you, although most of them have a weight gain risk. CrazyMeds has extensive information on most drugs used in bipolar disorder, including the full prescribing information for doctors. If you're willing to slog through it, you can find out a lot about the risks and benefits of various drugs (they do have shorter summaries of the important points).
In the end, you're going to need a doctor to change any of your meds (and you shouldn't stop them either without a doctor's supervision). You could try a google search for psychiatrists in your area, and try to find customer reviews for them. I think most insurance companies have lists of in-network doctors that you can search through as well.
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