Mood stabilizers are medications primarily used to manage significant mood shifts, such as those seen in bipolar disorder. They help individuals achieve emotional balance by reducing the intensity of extreme highs and lows. While these treatments are essential, concerns about potential side effects, particularly weight changes, are common. This article explores mood stabilizers that are weight-neutral or associated with weight loss.
Understanding Mood Stabilizers and Weight
Weight changes are a significant concern for many individuals taking mood stabilizers. Many commonly prescribed options, especially older ones, can lead to weight gain. This potential for weight increase can affect a person’s physical health and may impact their willingness to continue treatment.
Weight gain associated with some mood stabilizers can stem from various factors, such as metabolic alterations or an increase in appetite. These changes underscore the importance of finding medication options that align with a person’s overall health goals.
Mood Stabilizers Associated with Weight Loss or Neutrality
Several mood stabilizers are recognized for their more favorable weight profiles, ranging from weight-neutral to associated with weight loss.
Lamotrigine, often prescribed for bipolar depression, is generally considered weight-neutral. Less than 5% of individuals taking lamotrigine experienced weight gain, and some studies suggest it may lead to slight weight loss.
Topiramate, an anti-seizure medication sometimes used as an adjunct in mood disorders, is frequently associated with weight loss. Individuals taking topiramate can lose an average of 5% to 7% of their body weight over several months.
Zonisamide, another anti-seizure medication, can also cause weight loss and is occasionally used off-label for this effect. In one study, patients on zonisamide lost an average of 13 pounds over four months.
Lithium, a long-standing treatment for bipolar disorder, has often been associated with weight gain. However, recent research indicates that the extent of weight gain with lithium might be less significant compared to some other medications for bipolar disorder.
Lurasidone, an atypical antipsychotic, is generally considered weight-neutral or carries a minimal risk of weight gain. Some real-world data suggest it can be associated with weight reduction, particularly in those switching from other weight-gaining antipsychotics.
Cariprazine, another atypical antipsychotic, shows a low risk for weight gain. Studies indicate that the average weight increase with cariprazine is generally modest, often less than 2 kg over several months.
Factors Influencing Weight Changes
Weight changes experienced while taking mood stabilizers can result from a combination of pharmacological and non-pharmacological factors. Pharmacologically, some medications can influence metabolism, leading to more energy being stored as fat. Certain drugs may also affect appetite regulation, potentially increasing hunger or altering satiety signals.
Some mood stabilizers can impact insulin sensitivity or affect gut hormones, which play a role in how the body processes and stores energy. These metabolic shifts contribute directly to changes in body weight.
Beyond direct drug effects, individual metabolic differences also influence weight response. Lifestyle factors such as diet and exercise habits, as well as the underlying mood disorder itself, can contribute to weight changes. For instance, depressive episodes can sometimes lead to weight gain, while manic phases might result in weight loss due to increased activity. Concurrent medications for other conditions can also play a role.
Navigating Treatment Decisions
Choosing the right mood stabilizer involves a personalized approach, carefully balancing effectiveness with potential side effects like weight changes. Open communication with a healthcare provider is essential to discuss concerns about weight and other side effects. Decisions about medication should always be made in close consultation with a doctor, considering the medication’s primary purpose of mood stabilization.
Mood stabilizers are not primarily weight loss drugs; their selection is based on their ability to manage mood symptoms effectively. Lifestyle adjustments, including a balanced diet and regular physical activity, are crucial complements to medication in supporting overall well-being. These habits can help manage potential weight effects and contribute to better health outcomes alongside pharmacological treatment.