Unfortunately, some medications that are necessary to treat serious conditions can increase the risk for other serious conditions. This is the case with some antipsychotic medications. They can be very helpful in treating schizophrenia, but can cause weight gain and increased risk for diabetes. Here's an article from the Harvard Mental Health Letter that describes a study on preventing these side effects.
Second-generation "atypical" antipsychotic medications may cause significant weight gain and increase the risk for diabetes and heart disease. A study reports that people with schizophrenia who gained weight after taking an antipsychotic were best able to shed pounds, and improve other aspects of physical health, by combining the blood sugar–lowering drug metformin (Glucophage) with lifestyle changes.
Researchers in China studied 128 adults newly diagnosed with schizophrenia who were taking a second-generation antipsychotic and who had gained more than 10% over their pre-treatment weight. The researchers randomly assigned each patient to one of four intervention groups. Patients in one group took 750 milligrams of metformin daily; those in another group made lifestyle changes and took a placebo pill; those in a third took metformin in addition to making lifestyle changes; and the rest took only a placebo pill. Lifestyle changes included a diet advocated by the American Heart Association and at least 30 minutes of moderate exercise every day. The intervention lasted 12 weeks.
The researchers assessed insulin resistance and obtained baseline measurements of weight, body mass index (BMI, a measure of weight and height commonly used to assess overweight and obesity), and waist circumference in all participants. People who received metformin in addition to making lifestyle changes showed the most physical improvement across the board.
At the start of the study, for example, participants had a mean BMI of 24.5 — at the boundary between what is considered normal and being overweight. By the end of the study, people who took metformin and made lifestyle changes lost a mean of 1.8 points on the BMI, people taking metformin alone lost 1.2 points, and people who made only lifestyle changes lost 0.5 points — indicating that many had returned to BMI levels considered normal. People taking only a placebo gained an average of 1.2 points on the BMI index, indicating that they had become overweight. All groups showed similar changes in insulin resistance and waist circumference.
Because participants had been diagnosed with schizophrenia for less than a year, were young, and were generally not obese, it's not clear whether these findings will apply to other patients. The authors note that Chinese doctors tend to prescribe low doses of antipsychotic medications as maintenance therapy, so this may also have mitigated weight gain.
Have you experienced weight gain due to a medication? How did you manage it?
Julie K. Silver, M.D., is an assistant professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. She is also the Chief Editor of Books for Harvard Health Publications.
Mental Health Letter
The field of mental health is rapidly evolving, and whether your interest is professional or personal, staying informed about these mental health issues is no easy job. The Harvard Mental Health Letter is a source of mental health news you can trust—and it comes directly from the more than 8,000 doctors and researchers at Harvard Medical School.
Are you Living With Diabetes? Connect with others with similar health concerns and issues. Click here to join the group.
This content is not intended to substitute for personalized medical advice, diagnosis, or treatment from your healthcare provider. Read our full disclaimer.
rate
email
print
link to this page
Comments: 4
But it comes with serious risks. By taking metformin, one risks eventually accumulating - due to its half-life - all sorts of toxic and even lethal levels of lactic acidosis and eventual kidney failure.
I work with many people who have been diagnosed schizophrenic, and am familiar with many of the serious complications arising from their medications' side effects, and then the many drugs they take to counter the side effects, and then the drugs to counter those side effects... It seems an endless parade that benefits the pharmaceutical industry and the kickbacks an MD gets every time he prescribes a drug.
A study done by the Finnish public health department on the treatment of schizophrenia suggested that the most effective treatment for this generally inherited disease but triggered by stressors in the clients' environmental circumstances, is a comprehensive social, familial, psychotherapeutic and psychiatric cooperative effort., where no one on this team actually holds the trump card. This way, a far more effective evaluation of the client can take place, especially in terms of anti-psychotics and their host of side-effect drugs. A study used by this Finnish research also suggested that a great deal of women have been erroneously diagnosed with schizophrenia... that it far more prevalent in the male population due to genetic codes in the X-chromosome of women that generally reduces their predisposition to exhibit schizophrenic symptoms, but that due to most psychiatrists being men, the natural inclination would be to misdiagnose a mood disorder as schizo-affective.
As I am a colorectal cancer survivor, I was appalled when I read that one side effect of this drug is that it predisposes people to develop colon cancer.
My doctor had no idea and was shocked (her words) to learn and later confirm this. I do not have diabetes, but my doctor was trying to help me lose weight. She told me that approximately 30% of us are unable to tolerate the side effects, so we gradually increased the medicine over five weeks.
Why did I lose weight? I didn't want to eat anything as I was too sick the entire time I took the drug. When I suggested to my doctor that increasing my exercise and diet changes might be a better solution, she was all for it. Too bad we didn't have that conversation earlier.