Mood stabilizers are medications used to treat mood disorders, such as bipolar disorder and severe depression, by regulating extreme shifts in mood. Weight gain is a common concern for many individuals taking these medications. This potential side effect is frequently reported.
Understanding Weight Changes
Mood stabilizers can lead to weight gain through several biological pathways, including metabolic changes, increased appetite, and fluid retention. Some medications affect the body’s metabolism, altering how it processes and stores energy, potentially leading to increased fat storage and elevated blood sugar levels through changes in insulin sensitivity.
Many mood stabilizers also influence appetite and satiety signals, leading to increased food intake, heightened hunger, or cravings for high-calorie foods. Certain medications can cause fluid retention or edema, contributing to an increase in body weight. The extent of weight gain varies among individuals, depending on genetics, lifestyle, and the specific medication used.
Specific Medications and Their Effects
Different mood stabilizers have varying propensities for causing weight gain, with some posing a higher risk. Lithium, a commonly prescribed mood stabilizer, can lead to weight gain, with an average gain of 10 to 26 pounds or 8% of total body weight. This is often linked to increased thirst, leading to higher consumption of calorie-dense beverages, and changes in metabolism or thyroid function.
Valproate (divalproex or Depakote) is another mood stabilizer frequently associated with weight gain, affecting up to 70% of patients. Weight gain with valproate can be significant, averaging around 6.4 kilograms, with the most pronounced increase occurring within the first few months. This medication has also been linked to insulin resistance, contributing to its weight-increasing effects.
Atypical antipsychotics, often used as mood stabilizers, include olanzapine (Zyprexa) and quetiapine (Seroquel). Olanzapine is associated with substantial and rapid weight gain, with patients gaining 0.9 kg per month or 6 to 10 kg within a year. This is due to its effects on brain receptors that regulate appetite, leading to increased hunger, food cravings, and a slower metabolism. Quetiapine also causes moderate weight gain, typically within the first 12 weeks, with an average increase of about 7 pounds.
Not all mood stabilizers cause significant weight gain; some are more weight-neutral. Lamotrigine (Lamictal) has a lower risk of weight gain, with less than 5% of users experiencing this side effect. Newer atypical antipsychotics like aripiprazole (Abilify), ziprasidone (Geodon), lurasidone (Latuda), and cariprazine (Vraylar) often have a more neutral impact on weight or may even be associated with weight loss.
Managing Weight While on Mood Stabilizers
Managing weight while taking mood stabilizers involves lifestyle adjustments and close collaboration with a healthcare provider. Adopting a balanced diet is a first step, focusing on whole foods, lean proteins, and ample fruits and vegetables. Reducing processed foods and sugary drinks can also make a meaningful difference.
Regular physical activity is important for weight management and overall well-being. Aiming for at least 150 minutes of moderate-intensity exercise per week, such as brisk walking, swimming, or cycling, is beneficial. Even short, consistent periods of activity contribute to positive outcomes.
Open communication with a healthcare provider is important for individuals concerned about weight gain. Discussing any weight changes or concerns allows them to offer personalized advice and support.
In some cases, medication adjustments, such as modifying the dosage or switching to a different medication with lower weight gain potential, might be considered. These decisions must only be made in consultation with a doctor to ensure mental health stability and avoid adverse effects. A doctor might also discuss pharmacological interventions, such as prescribing metformin, which has shown promise in reducing antipsychotic-induced weight gain.