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lithium and weight gain

If you are on lithium, have you gained weight? If so, did this happen seemingly overnight or was it gradual? Do you think it's a metabolic issue or a diet issue? When I quit smoking, for example, I gained 15 pounds in two weeks without changing my diet. It was a metabolic issue and I was told that in a few years things would straighten out on their own. I started smoking again right about two years later, so I don't know what would ultimately have happened.

My psychiatrist said I might not gain weight and even if I did it would probably be "only" 5 to 10 pounds. That is enough to need larger size clothes. I'm concerned because I have a lot of difficulty losing weight and had finally managed to get back into my clothes after gaining weight 3 years ago. I'm facing menopause and the weight battle will only get tougher. I'm scared to death. I think my clothes are already getting tighter...

Thanks for any responses.
38 Responses
585414 tn?1288944902
To me and a lot of people. Its a metabolic issue and a common side effect. It can be controlled with changing your diet but the urge to eat more and the metabolic changes with it won't stop. If you find it intolerable, Lamictal is one option that won't cause it.
607502 tn?1288251140
I did not gain weight on lithium but I sure have on Mirtazapine (Remeron).  

Weight gain is not a certainty on lithium nor on any drug but the majority of AD, AP, MS and a pile of other drugs used in mental illness treatment have Weight Gain as a possible side effect.
Avatar universal
thanks for your responses. I have been on Lamictal twice. It didn't seem to do anything at all. I don't have much of an appetite and, if anything, I've eaten less since I started the lithium. Guess I'll wait and see what happens.
Avatar universal
This is interesting as I have always associated lithium with weight gain and this is one of the reasons I have always been to worried to go on it.  Depakote has had the same side effect however!  I have found that a lower dose of the depakote did help but I had to make a decision - was it better to be slightly heavier but mentally more stable or happy with my weight but mixed up in my head.

It is very difficult because being overweight can also have an impact on how we feel moodwise.  I know that if I go past a certain weight I get very depressed, low self esteem etc.

Look very closely at your diet and fluid intake and try eating smaller meals but more often and also exercising where possible even if its just a 20 minute walk in the fresh air.
Avatar universal
A friend was on depakote. We called it the fat, sleepy drug. I won't take it after what she's gone through. There have been times she has been on 6 or 7 different meds at once and some of them were just to manage the side effects of other ones. Not for me.

I had high hopes for the Lamictal and was very disappointed. For a long time, I had managed to avoid almost all the meds that might cause tardive dyskinesia, weight gain or fatigue. That's why my bipolar went untreated for so long. I had been misdiagnosed earlier in my life and tried a whole bunch of other meds, so I'd had a lot of other side effects and just decided I couldn't tolerate a lot of them. The sad truth is that we don't have high hopes for the lithium. I know that the idea is probably to be positive about things, but sometimes meds aren't helpful and can do a lot of harm.

My diet is awful. Sometimes I don't eat at all for a couple of days. That's probably why I gain weight so easily. My body latches on and doesn't want to let go. I know what I'm supposed to do. Doing it is another thing altogether. I can start to do something and hours later I still haven't done it. I usually have good intentions, but somewhere along the way I'm sidetracked by something else. My biggest issue is that I get most of my calories from fluids. It is dry here and I do drink a lot. And, no, I don't drink water. I have never liked water and even though I've gotten plenty of lectures about it, I can't seem to learn to like water. It's funny because I have not noticed wanting to drink more because of the lithium, but it seems like I am on the verge of a urinary tract infection because when I have to go, I really have to go.

I have the opportunity for lots of exercise. Spent about 90 minutes outside in fresh, crisp, snowy 15-degree weather cleaning up after the horses. I have to be careful because I have a back problem, but I try to get out there. It's not easy with the agoraphobia. Sometimes, I have a real hard time getting outside. It was the absolute worst for me when we were boarding a few months ago so that we could use the facilities for training. Driving the car, dealing with people... It seems such a stupid thing to worry about, but it's overwhelming for some reason.  

I know what you mean about the weight gain and self-esteem. I had lost a lot of weight and was thinner than I'd been in probably 20 years. I was riding and had a nice, flat stomach. Then we moved to this place and everything fell apart. I gained 25 pounds over 2 years. I got rid of some of it, but I feel like a whale. I hate how my clothes look.  That is why I really, really hope that I don't gain anything on the lithium. It would be a huge blow.

Thanks for the input.
607502 tn?1288251140
The only way to fight the side effects is regular balanced meals and exercise.

Im interested - what are you drinking if not water?
Avatar universal
I like coffee drinks, milk, soda and juices. In the morning, it's hot tea if I haven't made it to the store and run out of my coffee drinks. I don't drink anything unusual, but I constantly have something to drink. It is extremely dry here and I had previously lived in humid areas. I'm always thirsty. We want to add a built-in humidifer system when we renovate the house. I get nose bleeds and alligator skin, especially in the winter. I don't drink as much when I visit my family. It's not dry where they live.

Depending on how bad the side effects are and how much relief I actually get, I may not keep taking it. It is one thing to get a good result and minimal side effects and another thing altogether to get minimal results and lots of side effects.

I looked at a lot of research before we started this. My psychiatrist gave me articles and studies from the past 4 or 5 years. I can't remember a lot of the details, but I did note that not that much has changed since my original diagnosis in terms of treatment. I'm not under the illusion that there is necessarily a medication for everyone. It's simply not true. If this works, then I think a lot will change in my life. If it doesn't, we may try something else. There's always a tradeoff. I have managed to stay alive and out of the hospital for over 20 years. If I can't/won't tolerate the side effects, we'll just have to deal with it. We'd previously discussed having someone move in here, so that is an option. I know - little Mary Sunshine, right?
505907 tn?1258372940
Okay, so lithium and Depakote make you fat. Guess which two drugs I am on. I have been all over the net and read all kinds of horror stories. Concerning Depakote - an article in "Time" magazine mentioned women who were120 lb going into a psychiatric facility being checked in a few months and being 200lb! I'm taking this stuff for depression and I'm about to lose my figure but I'm going to be more perky? Anyway, what I was searching the internet for the answer to was this question. "HOW does Depakote make you fat?" There's been some discussion of this here so I just thought I'd tack my inquiry on to this. Thanks.
607502 tn?1288251140
Water has no calories, no sugar and no weight gain.

Most people don't realise just how much sugar, fat and empty calories are in milk, juices and soda's and how much of a difference changing makes - I moved to diet coke from coke and lost 1/2kg a week.

Its hard drinking a lot of water and I sympathise, I try and drink as much as I can and still drink other things, its good to have an idea what you are taking into your body though and reading the nutritional information is an eye opener - for the average adult male 2-3 cans of soda a day add about 500-600 calories onto the diet and whole milk coffee no sugar adds about 120-170 calories as well, thats before you get to portion sizes.

Having seen what the US calls a portion for one im not surprised that the country has such a weight problem.. I was seriously amazed in Hawaii at what the people around me, mainly from the US mainland, considered a normal breakfast - at up to 1000calories there's nothing normal about it.

The trick I found to weight loss (and I managed to lose 30kg) is understanding what you eat, controlling what you eat, exercising and cutting out the junk food and snacks and lowering portion sizes.  Im doing it again now as I have put on weight on the Remeron.
Avatar universal
I'm not sure they know why so many of these cause weight gain. I tried to find out more info and got nothing definitive. That's why I asked here. I was wondering if anyone had kept tabs on exactly what they put in their mouth and whether or not the weight gain was the result of a ramped up appetite and more food. I know a lot of things can mess up your metabolic rate and that is something that takes time to fix - if you can fix it at all.

Avatar universal
What is the conversion for kg to pounds?

I'm not most people. Smile... I acknowledge most of my caloric intake is from fluids - in an average day, I would estimate about 800 calories. My coffee drink has only 100 calories (Starbucks Mocha Frappuccino Lite). Then again, sometimes I have two... Often, I ingest less than 300 or 400 calories of actual food - sometimes it's only a 100-calorie bag of popcorn or a pouch of tuna that runs 80 calories. On a really good day when I have my act together, I might manage a bowl of cereal along with the above. Not ideal. I'm well aware of that and it's a work in progress. I understand diet. What I wanted to understand was how this medication affected a person and, potentially, caused weight gain.

You are correct about portion size and obesity in the U.S. I am not wild about stigmatizing people, though, and often discussions about weight become accusatory or insulting. Smokers and the obese are the last acceptable folks to bash on. As a smoker, I get lots of unsolicited comments and advice. My overweight friends and relatives get dirty looks, especially if they eat anything. Apparently, they are never allowed to eat in public. What has happened to me before is gaining maybe 3 pounds a year. It's so slow you hardly notice. I've never become obese, but I have become closer to the average size woman than I'd like. The last weight gain was pretty sudden and unexpected so I am struggling. I'm naturally petite and small-boned. I should stay closer to 120 pounds than 140 pounds. My take on the health and exercise aspect is that we're all gonna die anyway. I've got good genes on my side. Lots of smoking and/or drinking people who were/are kicking around far into their 80's and 90's, so for me, the weight is more about vanity than health.

I wonder how many calories are in a typical English breakfast. I gained a little weight when we lived over there. It would have been a lot of weight if not for all the walking.  I don't think folks in the U.S are the only ones with high caloric intakes. One meaningful difference is that we have to drive here and exercise is something most of us have to plan as opposed to something we naturally incorporate into our lives. It's not the norm to walk anywhere and some people live in places where it wouldn't be safe to walk due to crime... Sorry, I'm just babbling at this point.

222267 tn?1253305810
I am on lithium.  The only weight I have gained is consistant  water weight.  My Pdoc told me this would happen.  He also said that Lithium makes you crave more sugar (because it's a salt) and to not drink juices and soda, which I don't anyways.  I can just look at water and gain a pound.  It's amazing.  I drink large amounts of water everyday of course.  I don't know if it helps or makes it worse.  Ya, I gained a few pounds.  I might have kidney problems down the road too.  I have to weigh the benefits and the negatives.  I'm staying on the Lithium.
I was on an extremely low dose of Remeron for a very short time because I  never sleep.  Talk about gaining weight.  I stopped immediately.  I refuse to take it.  I would rather not sleep, I was gaining weight so quickly.  Not worth the benefit to me.
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