At a recent meeting of the American Psychiatric Association, researchers presented a study suggesting that ziprasidone (Geodon) was less effective in treating acute mania in people with obesity or hyperglycemia (very high blood sugar level). The study was funded by Pfizer, which makes Geodon, and was done by looking at pooled data from previous studies performed by Pfizer looking at this medication’s effectiveness.

The lead author of the study, Roger S. McIntyre, Associate Professor of Psychiatry and Pharmacology at the University of Toronto, indicated that while the findings could be related to a need for higher doses in people with higher body mass indexes, it could also be that these differences in body mass and blood sugar could reduce the effectiveness of the drug at any dose. While this type of study is apparently uncommon in psychiatric research, it is actually quite important in helping us understand patterns of effectiveness in various medications used to treat bipolar disorder.

A recent study published in the Journal of Clinical Psychiatry entitled “Are Mood Disorders and Obesity Related? A Review for the Mental Health Professional” (McElroy, Susan L.; Kotwal, Renu; Malhotra, Shishuka; Nelson, Erik B.; Keck, Paul E., Jr.; Nemeroff, Charles B.) reveals a possible connection between obesity and mood disorders including major depressive disorder and bipolar disorder.

The study found that:

• Children and adolescents with major depressive disorder may be at increased risk for developing obesity.
• Patients with bipolar disorder may have elevated rates of overweight, obesity, and abdominal obesity. (Abdominal obesity is specifically related to higher risk of cardiovascular disease.)
• Persons living with obesity who seek weight-loss treatment may have elevated rates of depressive and bipolar disorders.
• Obesity is associated with major depressive disorder in females.
• Abdominal obesity may be associated with depressive symptoms in females and males.
• Most overweight and obese persons do not have mood disorders.

With this post, we continue our biweekly series on medications used to treat bipolar disorder and related symptoms. This week, we shift our focus from anti-seizure medications to atypical antipsychotics – also known as second-generation antipsychotics or atypical neuroleptics.

Many people who carry the bipolar diagnosis also carry something else – extra pounds – primarily due to the medications used to treat mania or depression. Atypical antipsychotics, including Zyprexa and Seroquel; anti-manics, including lithium and Depakote; and even some antidepressants have been known to pack on the pounds, despite a person’s best efforts to stay fit and trim.