Psych meds, weight gain and metformin

Posted by mcgrathj @mcgrathj, Apr 18, 2022

Hi,
I've been doing research on treatment-resistant bipolar depression (type II) and came across studies that indicate that newer approaches to antidepressant therapy are anti-diabetic (metformin, liraglutide) medication and/or anti-inflammatories. Apparently the theory is that symptoms of depression, obesity and/or insulin resistance, cognitive deficits and anhedonia are transdiagnostic so certain meds like metformin are being examined as a possible adjunct to help current antidepressants work better. Has anyone been put on metformin for psych-med weight gain (without type 2 diabetes)? How is your doctor handling this? My mood is better (year-long depression) but my cognition is sub-par and I suffer anhedonia. Thanks for reading. Comments are welcome!

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Hi @mcgrathj and welcome to Mayo Clinic Connect. This is very interesting. I have not heard of adding metformin to psych meds, but with what you have described it is pretty sound logic. I do know that there is a slight chance of experiencing confusion while on that medication.
Have you started metformin already or are you just discussing with your doctor?

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@amandaa

Hi @mcgrathj and welcome to Mayo Clinic Connect. This is very interesting. I have not heard of adding metformin to psych meds, but with what you have described it is pretty sound logic. I do know that there is a slight chance of experiencing confusion while on that medication.
Have you started metformin already or are you just discussing with your doctor?

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Hi @amandaburnett, thanks for the welcome. I have not begun metformin yet as I'm awaiting blood tests but I am discussing this with my GP. My psychiatrist is pretty old school and won't try anything novel until it appears in the CANMAT guidelines. :(. Metformin and liraglutide has been studied primarily with antipsychotic-induced weight gain, yet as I mentioned it is being looked at for repurposing as an "antidepressant". It has a favorable safety profile. I don't know much about the med, so I haven't heard about confusion. I'm definitely interested in other people's experience with this med. Thanks for responding. Just curious, are you a medical professional?

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When I was told that I was borderline diabetic was put on metformin and could not get out of bed and depression worsened.

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I was put on metformin years ago for weight gain I experienced from gaining over a 100 lbs from Zyprexa. It kept me from developing full blown diabetes....but I did develop insulin resistance.....no brainer.....I was 248 lbs....the metformin got me down to 210....at least some....but Zyprexa is viscous about stopping your metabolism..so even the smallest food doesn't get burned off.
I since stopped Zyprexa....the withdrawals were horrendous.....medical marijuana helped alot. I've lost 31 lbs in 2 most and feel awesome. I'm not on any antipsychotic..just a mood stabilizer that doesn't cause weight gain. Stay clear from the atypical antipsychotics...they will destroy your health in the long run.

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@sage50

I was put on metformin years ago for weight gain I experienced from gaining over a 100 lbs from Zyprexa. It kept me from developing full blown diabetes....but I did develop insulin resistance.....no brainer.....I was 248 lbs....the metformin got me down to 210....at least some....but Zyprexa is viscous about stopping your metabolism..so even the smallest food doesn't get burned off.
I since stopped Zyprexa....the withdrawals were horrendous.....medical marijuana helped alot. I've lost 31 lbs in 2 most and feel awesome. I'm not on any antipsychotic..just a mood stabilizer that doesn't cause weight gain. Stay clear from the atypical antipsychotics...they will destroy your health in the long run.

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Doctors know this and hand these scripts out like candy. My former doctor wanted me to take Seroquel when I began tapering Xanax. He dumped me when I refused.

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@sage50 Agree with your commentary. Medications are the first quick fix as opposed to getting to root problem. One psychiatrist asked me as to what is your goal and my response was “ to never see you again” referring to my getting better. Shortly after that I was dropped as patient with no warning!

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@sears

Doctors know this and hand these scripts out like candy. My former doctor wanted me to take Seroquel when I began tapering Xanax. He dumped me when I refused.

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Smart decision...sereoqel causes diabetes down the road and outrageous weight gain...its in the same family as Zyprexa.
Once these Dr's get u on these meds, it's almost impossible to get urself off...your own body fights itself.
If you google " how to come off Zyprexa "....you will get thousands...endless...sites..posts....of patients on it trying to come off and can't. PEOPLE...HUMANS!!!.... who are suffering with terrible health problems and have tried many times...but the withdrawals are just too much...even with tapering down to near nothing....once you stop...
You're whole system goes haywire!!
And this is not from an addictive substance!!!!
So many people need answers...they are dying...and want to be saved....
I was on several of those sites not too many moons ago looking for any clue I could use. When I found out I was getting diabetes from my Dr's ....I imagined a life in my 50s giving myself shots..weighing 250..barely being able to walk without losing my breath...having a stroke or heart attack.....
THIS IS IMPROVED QUALITY OF LIFE?!?!?!?!..... ISNT THAT WHAT THESE MEDS ARE FOR IN THE 1ST PLACE????
IS IT TO DUMB US DOWN, SO WE SHUT UP, BEHAVE, AND FOLLOW ORDERS????
OR ARE THEY TO TREAT AN ILLNESS IN THE MOST RESTRICTED MANNER??..... WHICH IS THE LAW....AND RESTRICTED MANNER CAN BE ALL INCLUSIVE IF IT PERTAINS TO RUINING YOUR HEALTH.
by the way my friend....it is AGAINST THE LAW TO BE COERCED IN ANY MANNER, REPRIMANDED, OR SUFFER ANY NEGATIVE CONSEQUENCES BY ANYONE WHO IS TRYING TO GET YOU TO TAKE ANY MEDICATION AGAINST YOUR WISHES!!!!!
every patient should know that...bc too many Dr's throw their med degrees around!!!
In closing....I have found a Higher Calling for my 11th try at coming off Zyprexa and finally being successful.
I NOW can be the one person who can go back on those sites I used to visit where others cry out for help....and TODAY I'm not looking for help also.....but am offering my own testimonial with Zyprexa cessation. Perhaps I can teach others how to help themselves get back on the REAL road to recovery....what being healthy feels like, and by having Faith in your own mind's ability to overcome anything,..
Our real strength starts with ourselves 1st. Even my Spirituality originates from within.
Strength is not a pill.................................the VA psych Dr's had me believe 30 yrs ago I couldn't live without them. I wasted all those years sick and messed up from the drugs...115 hospital visits = 5yrs of my life locked up for serving my country??
I wish I saw the Light sooner. But now I'm still young and healthy enough to start life over at day one and try to only look back when it comes to sharing with others the flaws in the MH system that can cause harm.
I talk 2 much ;^)
Peace!!!!
Best wishes!!!..... stay sharp...ok to say no if ur gut is telling u.!@
Lv. Audrey
Today I look back
I learned

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Great, informative reply! Unfortunately doctors want us to trade one addictive medicine for another. We have to be so careful with this. It was my wish to taper Xanax. I had developed tolerance to the drug, it had stopped working. His remedy was to prescribe yet another addictive medication which, in my opinion, had much worse side effects. As you said, addiction, major weight gain, good possibility of developing diabetes. Not to mention the horrendous withdrawals for most. I still can’t figure out why benzodiazepines have completely fallen out of favor. The antidepressants, antipsychotics, the doctors want to prescribe now are just as bad if not worse. To top it off they really aren’t effective. Has everyone seen the new study on antidepressants? The joke med of the century, the horrible med the doctors can’t hardly wait to prescribe. The cure all for everything from PMS to depression to hot flashes. I could go on and on. I never had any side effects from Xanax except relief from my debilitating anxiety. This is in reply to sage50.

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I commented on this topic with metformin used for weight gain associated with antipsychotics.......but I didn't really say much about its effectiveness on helping vs. no change on depression.
I was on a 32 yr long treatment-resistant major depression. I tried every med out there plus ect....still felt pretty messed up. My Dr put me on the metformin about 7 yrs ago...about the same time I started doing TMS.
I did 2 separate rounds of TMS and a six month refresh round.
THAT made the biggest difference of anything in my life. Went from night to day.....with the exception of still being on some nasty meds.....and having tons of therapy that needed to be done.
I've " been in therapy" since I was a young 19 in the army....and I'm 55 now...and I'm actually " in" therapy.
Meaning.....I mentally wasn't ready until the past couple years to be " present enough" to be able to be a participant in an activity that required me to understand who I really was, why, why I acted the way I would or react, what my real needs were...and not just what sounded good...what made me happy or sad...or.....WHY WAS I SAD IN THE 1ST PLACE????.....thats a good one I tried to figure out for half my life but couldn't!!!
There's so so much about being ready cognitively for therapy....and our illnesses....whatever they may be....impair our preparedness...even though we may be of the most motivated.
Depression is especially rough on therapy if you're experiencing adhedonia....if you can't feel....and I totally get that....than how do you deal with emotions that you have no access to. Yes, you have to lift the depression to try and lift the other....but relying on something you can't control .....like a pill....is not giving yourself a completely full chance.
We are all about balance. We are housed in physical bodies....their health greatly contributes to our MH. I've found for depression, one of the most helpful tools is exercise. Eating right, cutting carbs, proper h2o intake, getting 8-9 hrs sleep/night, getting outdoors and watching around us...getting out of ourselves.....work...volunteering...talking to our peers....abstaining from d and a...quitting smoking.....
Spiritual practices....whatever your choice be.....music....art......hobbies....going out and doing good things for strangers for just the sake of it, and not telling anybody about it...tell everyone you meet today " hello".... watch them say it back....see how u feel!... pick up pieces of trash everywhere you walk and throw away for an entire day....tell one person every day that you love them....even if it's a pet....
Why am I saying this?????
YOU HAVE TO MAKE YOURSELF FEEL....NO ONE MAY...CAN....OR WILL. YOU..AND ONLY YOU CAN!!!!
PEACE TO YOU!!!!!
AUDREY

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@sears

Great, informative reply! Unfortunately doctors want us to trade one addictive medicine for another. We have to be so careful with this. It was my wish to taper Xanax. I had developed tolerance to the drug, it had stopped working. His remedy was to prescribe yet another addictive medication which, in my opinion, had much worse side effects. As you said, addiction, major weight gain, good possibility of developing diabetes. Not to mention the horrendous withdrawals for most. I still can’t figure out why benzodiazepines have completely fallen out of favor. The antidepressants, antipsychotics, the doctors want to prescribe now are just as bad if not worse. To top it off they really aren’t effective. Has everyone seen the new study on antidepressants? The joke med of the century, the horrible med the doctors can’t hardly wait to prescribe. The cure all for everything from PMS to depression to hot flashes. I could go on and on. I never had any side effects from Xanax except relief from my debilitating anxiety. This is in reply to sage50.

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All Dr's are cutting the use of benzos....they are getting pressure from the government to do so....it isn't them.
I'm on Ativan now for 12 yrs?... a decent dose. I'm used to it...but 2 weeks ago my Dr tried to cross titrate me over to Xanax and physically it was so uncomfortable, I told them to forget it, and just keep me on what I'm on. But he did chop my Adderall in half bc he said he has been audited b4 for a similar case, even though the combo works 4 me, it doesn't look good on paper.
That's what the government sees...not the patient and whose using it responsible and whose not.....bc benzos CAN be dangerous.
My best friend Jamie, 🙏 RIP...died from an Ativan OD.
People do. It causes respiratory arrest if mixed with alcohol or with other meds or if too much is taken....and the line isn't clear where death happens...bc some can cheat it........others not so lucky.
My PA at my psychs told me the office cut 75% of their pts off benzos...and it wasn't easy for her...bc she knew it was hard on some more than others. They only kept me on bc of my history with the military and having ptsd and being hypervigilent and needing it to be able to function...I refuse antipsychotics bc....I am not psychotic.....and I just gave everything I had to get off one. I've been seeing the same office for 16 yrs....they know me and my case...and trust me enough to justify my case to anyone who asks.
This is what was explained to me.
So.....I wouldn't get offended by ur Dr's actions,bc u are part of today's collective....the world we now live in.
I have radiculopathy and it hurts like no tomorrow. All I get is tramadol....bc people out there decided to take advantage of pain meds....now u can hold ur mris right up to ur Dr's nose and say here..look!!!..... but they will send u to pain mgmt...and they will send u for pt...or acupuncture.....
But no pain meds.
Same story with benzos....people ruined it for others.
That's why I'm on MM....can't say on here what it stands for...but....one little puff at bedtime takes care of my insomnia....otherwise..the pain used to keep me up till 4am...nightly....and I regressed...couldn't heal without sleep.
Mentally, you can't heal without sleep either. Needs to be researched....perhaps???.... anti-anxiety better than benzos...natural....no overdose...effective...good for depression too....helps big time with withdrawals.
Gotta run.....haircut appointment.....
Catchya more later.
Be cool...peace...BE WELL!!!
AUDREY

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