I have been fortunate in my life to
have never needed any psychiatric drugs. While I have had two
periods of minor depression during my battle with diabetes, and a few
weeks after my first wife passed from cancer, I was fortunate
that I had some people around me that pushed me into a positive
attitude after my wife passed and told me to find the positive in her
passing.
Now that I know what the drugs do to
people taking them, I will need to refuse them if a doctor attempts
to prescribe them for me in the future. In the medical community,
antipsychotics are well known to cause significant weight gain.
Gains of 20 to 35 pounds or more over the course of a year or two are
not unusual. Doctors seldom warn patients about this side effect.
The situation is not uncommon, according to psychiatrist Matthew
Rudorfer, chief of the somatic treatments program at the National
Institute of Mental Health, who points out that although the U.S.
Food and Drug Administration carefully tracks acute side effects such
as seizures, it pays less attention to longer-term complications such
as weight change. Perhaps taking their cue from the FDA, doctors
tend to downplay weight-related risks that accompany many psychiatric
drugs, Rudorfer says. For many, the weight gain is not trivial.
Antipsychotics
According to a 2014 review of eight
studies, as many as 55 percent of patients who take modern
antipsychotics experienced weight gain. This is a side effect that
appears to be caused by a disruption of the chemical signals
controlling appetite. Olanzapine (Zyprexa) and clozapine (Clozaril)
are the top two offenders, as studies have shown that on average
these drugs cause patients to gain more than eight pounds in just 10
weeks. These two drugs also bear the highest risk of metabolic
syndrome, which encompasses weight gain and other related disorders,
including type 2 diabetes, according to a 2011 study of 90 people
with schizophrenia.
Antidepressants
A 2014 study of 22,610 people revealed
that antidepressants generally cause more modest weight gain than
antipsychotics, although the outcome varies greatly from one drug to
the next. Of the 11 antidepressants analyzed, mirtazapine (Remeron)
caused the greatest weight gain, followed by paroxetine (Paxil). A
quarter of those who took mirtazapine for a year gained more than 7
percent of their initial weight. Only one antidepressant, bupropion
(Wellbutrin and other brands), was associated with a small degree of
weight loss.
Depression itself, however, is linked
with an increased risk of becoming obese, according to a 2010
analysis that included more than 58,000 people. The reverse holds
true as well, the study found; obese people are more likely to suffer
from depression. As a result, “it is easy to misattribute the
weight gain to a medicine when, in fact, it may largely be related to
the illness being treated,” cautions Richard Shelton, a professor
of psychiatry at the University of Alabama at Birmingham.
Stimulants
Typically used to treat
attention-deficit disorders, stimulants such as Ritalin are
consistently associated with weight loss. Many stimulants are
specifically marketed as antiobesity drugs, including phentermine and
lisdexamfetamine dimesylate (Vyvanse), which earlier this year became
the first drug approved for the treatment of binge-eating disorder.
Although the evidence is limited, early studies have shown that some
young adults abuse prescription stimulants for weight-loss purposes.
About 12 percent of the 705 undergraduate participants in a 2013
study reported that they had attempted to lose weight by taking a
stimulant without a doctor's prescription.
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