Weight gain is a serious issue for people with bipolar disorder and schizophrenia. People with these disorders are more likely to be overweight than the general population. Up to 63% of people with schizophrenia and 68% of people with bipolar disorder are either overweight or obese. This can lead to a number of physical and mental health problems including cardiovascular disease, metabolic syndrome and cognition problems. Antipsychotic medication can be a significant factor in weight gain in those with schizophrenia or bipolar disorder. Lorasidone (Latuda) may be an exception to this rule.
Approximately 60% of people with bipolar disorder take antipsychotics as maintenance treatment and half of those are likely to gain weight using them, often leading to nonadherence to treatment. In the first year of taking these medications, patients may gain as much as 35 pounds (16kg). The reason for this is that antipsychotics affect hormones, proteins and enzymes that at least partially control appetite. Appetite is increased, satiety is decreased and glucose levels are thrown off.
Some antipsychotics are more likely to cause weight gain than others. Examples of antipsychotics that are most likely to cause weight gain are clozapine (Clozaril) and olanzapine (Zyprexa). There are also antipsychotics considered to be more weight-neutral like aripiprazole (Abilify) and ziprasidone (Geodon).
Lorasidone (Latuda) is another antipsychotic frequently used to treat both bipolar disorder and schizophrenia. Over the short-term is has been known to be among other antipsychotics that are weight-neutral. A new study from the Annals of General Psychiatry looks at how lorasidone affects weight in the long-term.
Jonathan M. Meyer, of the University of California, and his research team followed 439 patients over the course of a year to see how their weight changed after being prescribed lorasidone. The prescription was new at the beginning of the study and lorasidone was the only antipsychotic taken by participants during the period of the study. The average amount of time participants were taking lorasidone was 55 days.
Patients taking lorasidone initially lost an average of 1.7 pounds (0.77kg). Over the course of the study, those who had switched to lorasidone from antipsychotics that were at higher risk for weight gain lost an average of 3.7lbs (1.68kg). Those taking lorasidone were also likely to experience a decrease in BMI.
These weight changes may not seem significant, but going from a drug that increases weight by almost 35 pounds in a year to one that may decrease weight at all is a good step in combatting the effects of obesity.
In addition to switching to a more weight-neutral medication, weight loss with bipolar disorder or schizophrenia is the same as it is for anyone else. Diet and exercise are the most effective ways to lose weight and maintain a healthy weight.
If you are dealing with weight gain due to antipsychotics or have discontinued treatment due to weight gain, it’s important to talk to your psychiatrist. There are many options for treatment for both schizophrenia and bipolar disorder. It just may take some time to find the right treatment for you, personally.
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Image credit: Kathea Pinto