1. < Depression & Anxiety

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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sears | @sears | Aug 12, 2022
In reply to @sage50 "All Dr's are cutting the use of benzos....they are getting pressure from the government to do..." + (show)
@sage50

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

Jump to this post

I was with my doctor 25 years, I never had a problem. I assume he trusted me, there were never any issues.

REPLY
sage50 | @sage50 | Aug 13, 2022

Did you come off of the Xanax yet, or just in the talks???
I was wondering how you were doing with withdrawals, seeing that you've been on it for so long.
Dr's need to be careful of the threat of seizures when d/c pts from benzos....so keep that in mind if he tries to just cut u off...or wean u too fast. Also, anticonvulsants should be in place if he thinks that ANY MED LIKE ANTIPSYCHOTICS OR SUCH.......besides another benzo.....or a rehab protocol.... is a suitable substitute for getting you off them.
Just be careful if u still haven't come off them yet.
I had a Dr about 25 yrs ago...Chief of Psych for the hospital, actually..lol!!...... she tells me..." you stop Lamictal tonight...not helping...we switch you to different med...one better for you...so, you can just stop the Lamictal and start the lithium.....
So , I did what she said. No tapering......1-2-3.... new med....
1.5 days later I was out shopping with my sis...I started feeling weird in the store...told myself it was just anxiety and you'll get through it, just focus on shopping....
That was the last thing I remembered until 4 hrs later....when I regained consciousness.
My sis told me the store worker yelled....someone's down in aisle 2!!
My sis ran over and told her to call 911 and that I was having a grand Mal seizure. I woke up in the er 4hrs later and transferred to the icu at the same hospital she worked at. The neurologist knew why I had the seizure, and it was charted...yet he still had to turn it in to Penn dot...I lost my license for 6 mos.had to move closer to the city..break my lease...drop out of a job training program I was in for a federal job.
To top this off.....2 Mos later, I'm at an outpatient appointment with some young cocky neurologist who asks me if I'm still drinking.
I told him I haven't drank in 3 yrs. He steps out..I see my chart on the computer screen and take a look.
" cause of seizure in patient: ETOH usage while on disulfarim ".......
She went into my records, the Dr who caused the seizure, and changed what happened bc she was at fault and knew she would have to answer for it!!!!
I went to court to fight my license suspension. The judge asked me if the VA admitted to it. I told him...really, do you think they're going to take responsibility????
He said no....probably not. And gave me a continuance.
In the mean time, these 2 guys dressed like ' men in black' approach me and give me their cards and tell me they are here for me and to call them. Their cards had some federal agency name on it and their titles.
They got me permission to keep driving...somehow.
Years down the road I ran into that attending neurologist from icu when I was an inpatient. He remembered me! Yes, he said....you are the one who had the seizure from our Chief d/c your meds cold turkey!!.... someone knew the truth!!!!!
Long story.....short message.
DONT LET YOURSELF BECOME A VICTIM .....ANYTIME , ANYPLACE, ....BY ANYONE!!!
ALWAYS ASK QUESTIONS....QUESTION WHAT DOESN'T SEEM RIGHT, TRUST YOUR GUT, EDUCATE YOURSELF.....BE YOUR OWN ADVOCATE!!!! JUST BC SOMEONE TELLS U THEY WANT U TO TAKE POISON, AND YOU SHOULD LISTEN TO THEM BC THEY ARE A DR,...ARE YOU STILL GOING TO TAKE IT?????????
you know....that sounds absurd...yes?????
But there are millions of psych patients doing that very same thing. Who is protecting them???...where does that patent end up??..... many many times in a far worse place than from the start.
Been there, done it!!!
I wish when I was 20, someone told me I had a voice. It would have saved me from years and years of things the system did to me that were unimaginable and illegal.
I will save that story. It is sad....but a catalyst to developing compassion. For that...I am Grateful.
With that,....I shall end for now. %^]

REPLY
marjou | @marjou | Aug 13, 2022

@sage50 Am chiming in here about Lamictal which is very dangerous drug which I have reported by awful reaction to the FDA. Started off ok small dosage but my body seemed to react in the form of sort of paralysis ( no nerve feeling from neck down). Had to do a quick tapering off of this medication…very frightening.

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catmomma | @catmomma | Aug 14, 2022

Hi,

I have bipolar (I) and I absolutely hate the weight gain medications cause. As a woman, and given how society is about women and weight, this is a sore point for me. For a lot of reasons. I got angry with a psych-family practice provider who made it sound so easy when she dished out the advice that I should "calorie count...eat 1500 calories a day and increase your step count." Too many things to count with that one, but I am 5'10 and built like the men in my family so that was a bit low. But I have a master's in nutrition and am also a nurse (psych), and went home and calculated (with my text book) something more realistic: 1800 calories a day-and that's with 500 subtracted from my energy needs to lose weight. But there's problems with that.

The other thing that made me angry was she made it sound so simple. When I take one of the atypical antipsychotics which are horrible on weight gain, it's very easy to make it sound so simple.

It's frustrating to see our doctors (no, I don't work at Mayo) use meds that cause such severe weight gain and know that when our patients do leave us, they will get it from regular medical providers about how they should "try some weight loss." As this has been MY own experience. My opinion is this issue is tied closely to the one on non-compliance. (it has been for me). I've got an appointment with a new family med provider and she doesn't know it yet but she and I-we will be having a "come to Jesus" about any future discussions or comments from ANY provider on my healthcare team!

A patient said it best to me once: "I think all doctors need to be on the receiving end of any of the treatments they prescribe." I could not have put it better myself!!!!

Just a thought.

REPLY
santafegal | @santafegal | Aug 17, 2022
In reply to @sage50 "I commented on this topic with metformin used for weight gain associated with antipsychotics.......but I didn't..." + (show)
@sage50

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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What is TMS?

REPLY
sage50 | @sage50 | Aug 17, 2022

Transcranial magnetic stimulation. It's a treatment for severe depression that's not so invasive and done in the office without the use of any sedation...so you can drive home urself after ur 40 min session...but my Dr's office requires it 5x a week....I've heard of other Dr's office's having different protocol.....so???
But...its very effective......for myself..I've found....and I've been on every antidepressant out there...thats why my Dr was happy when they came out with it approximately 7 yrs ago...I tried ECT...but had neuro side effects and had to stop course.
Most insurance companies will pay for it, as it is expensive....but to them it's cheaper than long term costs that depression has for their clients. I know mine is thrilled they're not getting my 3grand$ /night hospital bills!!!
To find more about it, Google it on different sites so u get a better pic of it...in case ur serious about having it. It's not painful...except there is a 30 sec intervals of " tapping sensation " on ur head that gets a bit sensitive....it used to give me a slight headache...but Tylenol easily took it away.
Also..you have to wear earplugs. My tech who runs the machine let me put my music buds hooked up to my phone and jam. It made time fly and was a bit enjoyable bc I got to listen to my Playlists.
It takes about a week or two for most to kick in....I felt a difference after 3 sessions...which isn't a surprise bc I had been in a 25 yr treatment resistant severe depression and even the smallest improvement felt immense.
I improved so much mood-wise, and came out of my isolative socially shell, that my Dr asked me if I would give lectures for prospective clients on the procedure. I did well, as I became an empowered and confident person...outgoing...well educated about the process ( I went through 2 rounds bc of being in depression for so long).... I felt respected by the Neurostar reps....which was a HUMONGOUS thing...bc my self-esteem was at rock bottom from all the years of feeling worthless......I can't explain how grateful I am that I went through with it.
Is life today rainbows and sunshine 24/7 ????.....no!!
It would be irrational to think so.....but TMS built a strong foundation for me to build upon. It gave me.." that chance".. that I didn't have b4....I used that foundation...and it was solid...and upon it, I built structure, relationships, self-care,meditation, spiritual practice,exercise, hobbies,intellectual studies of Eastern philosophy, humor....LOTS OF HUMOR ....AND MUSIC.....MUSIC HEALS!!....SO DOES NATURE AND THE LOVE OF AN ANIMAL. ......HUG SOMEONE TODAY!!! OR SOME BEING...IF YOU DONT HAVE A PET, SHELTERS LOVE VISITORS AND DOG WALKERS!!!... UNCONDITIONAL LOVE!!@
LOVE HEALS ALL WOUNDS.......
enough of my lectures...I get so excited to share...I came from being forced into living in a group home 22 yrs ago..to now owning my own home.....breaking free from a system that kept me a prisoner and almost killed me. Thank THE Great God's and Angels who saved me and brought me to my present Dr of 15 yrs..a private Dr, who treats me like a valuable human, not a case #.
So...that I give you...and hopefully some encouragement.
Be well. Peace. Audrey. :^)

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