Medications for bipolar that don't cause weight gain?

Hi Sage,
Similar story for me with that drug from hell. I was on a relatively low dose of Z for about 10 years and had gained almost 70 lbs above my cruising weight of 200. I also saw alarming increase in blood sugar, pushing pre-diabetes levels. The final straw was when the tics started and I became very fearful that I was developing Tardive Dyskinesia. Last Fall I began weaning off and didn't have too much trouble cutting dosage (titrated down 1/2 × 1/2 × 1/2 from starting point of 7.5mg/day) until the drop to zero. Then the withdrawls began and it got bad enough that I had to go back on it for a couple of months. I've been Z-free since April. I'm down to 185 lbs, but still waiting to see any significant improvement in A1C. Tics are gone. I didn't realize the paranoia and brain fog I'd developed were as bad as they were until they disappeared. And, so far I haven't needed a new antipsychotic, which is a moot point, because I will never go on another one. I changed shrinks, in part, because my last one always downplayed the severity of Z's side effects.
Sorry to hear you had such an ordeal detoxing. I guess I got lucky.

Regards
Itchy

I have tried many different things and combinations of things. The one that has best kept me out of the hospital is Zyprexa which is notorious for weight gain. My doctor and I accepted the trade off and I took Zyprexa. On July 9, 2022 i weighed 360 and my A1c was over 8. I had screened out of a bariatric surgery program due to depression. In the last 2 years a drug called Lybalvi has been introduced. It has the same active ingredient as Zyprexa plus samidorphan. The samidorphan is thought to suppress the food cravings that the Zyprexa causes. I enlisted the help of a Registered Dietician who is also a Certified Diabetes educator. I lost approximately 45 pounds over 9 months. The dietician suggested that I see an endocrinologist. The endocrinologist maxed out the dose of Innvokanna and started me on Mounjaro because my A1c was still around 8. The weight really started coming off then. I have lost 82 pounds since July 9, 2022. I still have a long way to go to hit my goal. I’m sure that without the Lybalvi, I wouldn’t be able to function and loose weight.

Dear Smitty,

Try any and all of the following, in various combinations:

1. Valerian
2. Herbal tea for sleep
3. Hot shower before bed
4. Meditating
5. Yoga
6. Tai Chi
7. Praying
8. Rubbing homemade ghee on your feet at bedtime
9. Exercise: more aerobic, strength training, and balance exercising

See picture for reference.

Joe

I’ve tried many things and combinations of things. Zyprexa worked better than anything else at keeping me out of the hospital. I gained about 120 pounds on it over 15 years. On July 9, 2022, I weighed 360 pounds, my joints ached, and my blood sugar was up. I started taking a new drug, Lybalvi. It has the same active ingredient as Zyprexa + samidorphan. The samidorphan blocks the cravings I had with Zyprexa. I have lost 82 pounds since July 9, 2022. We tried Lamictal and I started getting the rash. So I had to stop it. There’s another drug you might talk to your doctor about. Contrave is approved for weight loss. Good luck! Keep fighting.

The only treatments that I have found that address mental health without weight gain are diet, exercise and psychotherapy. In fact I believe they are the most effective treatments.

In June I was on fourteen medications I am now on four. I changed my diet to eliminate ultra processed foods and refined sugar wherever and whenever possible. I also increased my exercise regimen to ninety minutes six times a week.

I believe medication maybe needed to help the sufferer begin making lifestyle changes and start exercising. However, there is no substitute to eating a healthy diet and moving. Humans were not meant to sit around worrying while eating food the body does not recognize; not yet anyway.

Fifteen years ago I went looking for an answer in a pill. I found a doctor willing to accommodate me. All these years later I've lost everything thing that matters, save my life. It really is amazing that I had to lose my family, my freedom, my fortune and almost my life before I would take the simple (but not easy) steps of changing my lifestyle.

I just came from one of my doctors and we are implementing the second stage of my detox. If all goes well I will be off Venlafaxine, completely in six more weeks, Bupropion, four more after that and Lithium in three more weeks. All that will be left is a low dose of Latuda that shouldn't take more then a month after that. If this works, i've already reduced everything by at lest two thirds, I will be drug free for the first time in fifteen years.

What I have to do is simple, but not easy:

Sleep seven to eight hours a night. Same time to bed, same to to wake everyday. Including weekends.

Eat a clean diet. No ultra processed foods (food I can't pronounce), no refined sugar at all. Lots of vegetables, fiber and protein. Good fats and low to no saturated fats.

Exercise ninety minutes six times a week. For me I lift weights, hike and bike vigorously.

Pay attention to my feelings. Recognize what is jut my body asking to be taken care of and what are feelings I need to look at and try to understand the difference, psychotherapy helps a lot.

Do something with my time that I care about.

And try to live in the moment instead of the past or future.

Might seem like a lot of work. Compared with what I lost I am overjoyed to do the work!

This is my path. I hope you find yours!

Dear DFB,

Your post is awesome and on target. I suggest you read my book, Tools of Transformation. It aligns well with your approach but supplements it in a number of key ways.

I was on lithium for over 30 years and Lorazepam and Seroquel for more than 17 years.

I am medication-free and well now. Content, purposeful, and happy.

💞

Aripriprazole aka Abilify, does indeed cause a lot of weight gain. If you didn’t gain in this you’re very lucky!