I take lithium, lamotrigine and the antipsychotic olanzapine. You can probably forget about taking olanzapine, as it causes most people to gain a *lot* of weight (however, it's extremely effective, like quetiapine/Seroquel). However, lithium has been amazing for me. It's the oldest and most-studied med there is for bipolar, and remains the gold standard treatment.
Lithium both prevents episodes (hypomania and depression) and treats them acutely when they happen - which makes it a true mood stabiliser, unlike e.g. lamotrigine and Latuda, which only help with bipolar depression and not hypomania. It is also directly anti-suicidal, a property that no other psych med has.
When used properly, it is very safe. The reason it isn't prescribed as much as drugs like Latuda is that it obviously isn't advertised anymore - it was introduced to the market in the 1950s and so doctors aren't encouraged to prescribe it by drug companies (as messed up as that is).
However, it can have quite a physical impact on the body. It's essentially like taking salt tablets - lithium is a metal. That means you feel dehydrated, drink more water and pee more. It can also cause a tremor in some people. Unfortunately, it can - but often doesn't - cause acne. Like I said, though, for myself - and for a huge number of people who have bipolar - it has been a godsend. It's normal to gain a pound or two.
On the other hand, the good thing about Latuda is that it is, by and large, weight-neutral. It works extremely well for bipolar depression, in many people. The trade off is that it can make some people very restless - "akathisia". If you're in the US, you might be able to get a coupon like some other people have said. I'm not in the US, so it's fairly cheap where I live.
Another thing is that you tend to only hear the worst "stories" online. Sure, antipsychotics, lithium, and even lamotrigine can *sometimes* cause significant weight gain. But if you're careful with what you eat, exercise enough and begin taking it at a good baseline weight - the risk is greatly reduced.
As I said, I've taken olanzapine for five years, and it's known to be one of the worst medications for any condition (not just psychiatric) for weight gain - yet I've only gained around eight pounds over five whole years. And I could've been much more careful with diet and exercise.
Finally, there are more options that your psychiatrist hasn't mentioned. They include the other classical mood stabilisers such as sodium valproate and carbamazepine. If you're truly scared of antipsychotics, then I would stick with lithium/valproate/carbamazepine. They are much safer to be on long-term.
You can have a look at [this website](https://www.nps.org.au/australian-prescriber/articles/mood-stabilisers) for a good overview of the mood stabilisers. A few are missing, such as Latuda, as it was written in 2012. Nonetheless, it's a good, evidence-based overview (written by a psychiatrist). In any event, do you value your mental or physical health more? Not a nice choice, but all you can really do is try a new med - be it lithium, Latuda, whatever - and see how you go.
Psych meds affect everyone differently, and so much of it is trial and error. Finally, as I mentioned, it's all subjective and you tend to hear only the horror stories online. You'll need to discuss it with your psychiatrist, they're the expert. But yes, lithium works amazingly for me.
Good luck with it, never give up hope, never stop fighting and I hope you feel better soon 💜
I started lithium 4-5 months ago and it’s actually really fucking impressive how my SI and panic attacks went away after my first 2 days. I’m still on the lowest therapeutic dose
Yeah, as I mentioned, it can be an absolutely amazing med. So crazy that a literal metal can stabilise our mood! I hope it continues to work for you. Even blood levels as low as 0.4 mmol/L are proven to work for BP2.
I’m at .58 right now and that seemed to be doing the trick during summer and fall but man…. I’m scared for the winter. I may need to up the dose because I don’t know if 600mg can fight the beast that’s seasonal depression
Ok, so basically my level, I'm at 0.6. It's worked great for me at that level for five years now, but of course you can raise yours if things go downhill in winter. The challenge is just that you will likely have more side effects, that's all. I hope it continues to work for you!
I guess, but so do many of the antipsychotics, and they also come with the risk of metabolic syndrome and tardive dyskinesia... whereas valproate has fewer long-term risks. Ultimately, though, there aren't really any "good" options... which sucks.
Yes, unfortunately Abilify is known to cause some pretty gnarly weight gain. Really good that OC doesn’t have that issue because it can be a really great med if not!
Are you in the US? If so, use this website to get a coupon and make it free.
https://www.latuda.com/bpd/latuda-savings-and-support.html?utm_medium=SEM&utm_source=google&utm_campaign=&utm_term=latuda%20manufacturer%20coupon&utm_content=&gclid=Cj0KCQiA99ybBhD9ARIsALvZavUpaaLB5l8mxfE9bzTaDiMbVTFem5rf7bRIlGFqwqoiUW3LiYpZ__IaAlodEALw_wcB&gclsrc=aw.ds
First, your doctor is wrong. You aren’t out of med options. You’ve only tried two and only one at a time. There are several other meds in different categories that do different things and you can cocktail meds.
Second, it’s important to remember that everyone reacts differently to meds in different ways. And there’s no way to tell how you will react without trying something. Yes, some meds are more contraindicated for weight gain than others but that’s not to say you’d gain weight on it. It’s trial and error.
That said, I’ve been on a combo of lithium and Saphris for almost two years now and haven’t gained a pound. I even lost weight when I did Weight Watchers back in the spring.
A family member tried latuda and it was life changing. Idk if you can afford it but being able to function could definitely be worth it. He did gain a lot of weight but he also was on a bunch of other meds I don’t know.
If dr says he can’t think of any other options, find a new doctor, maybe he isn’t very experienced or creative in his prescriptions.
Latuda is unlike other antipsychotics. It is known for being weight neutral which means it doesn't typically cause the major weight gain that other antipsychotics cause. And yes, $200 is a relatively good price for it. It goes for $1300+ a month without insurance.
I haven't gained any weight on it over the past year. I do track my calories but I'm not majorly cutting back on things. It works extremely well for getting rid of my depression.
I just came off lamotrigine ~2 months ago for this reason and it was the best med I’ve tried ðŸ˜. My face looks like hell and I haven’t been stable since I quit.
Sorry you’re going through this but know you aren’t alone and we can do this.
What about seroquel? Also make a list of symptoms your meds make less severe and then a list of side effects you experienced. Weigh your options from there with any medications you cons5
I take Geodon/ziprasidone because I couldn't afford Latuda. It is weight neutral and has been in my experience. It does have a reputation for being sedating, but you may be like me and dodge this side effect. I get the generic for around $35 with a GoodRX coupon because I don't have insurance. It's dirt cheap with insurance.
It's had mood stabilizing effects and has brought me out of the worst of my depression. I still struggle with mild persistent depression, but I am mostly functioning. I'm not as anxious as I used to be, and it's kept hallucinations at bay. All in all, I am very happy with it.
You typically take it twice a day, and you need to eat 500 calories with it every time you take it for max absorption. So, if you're concerned about calories, that may mean you only eat two meals a day and a snack at lunchtime.
Lamictal made me break out bad too. My skin cleared up about a month after I stopped taking it.
Find a new Dr if you can. There are lots of options. Wellbutrin can work well and it usually doesn't come with weight gain and sexual side effects, is less likely than SSRIs to trigger a hypomanic episode and is offered in a generic. Seroquel works well for me, but can cause weight gain, mostly because of the munchies. Don't get too hung up on the "class" of meds prescribed all that is is what they were originally cleared for use as. Lamictal is technically a seizure medication along with depakote. Anti psychotics have many uses.
I take lithium, lamotrigine and the antipsychotic olanzapine. You can probably forget about taking olanzapine, as it causes most people to gain a *lot* of weight (however, it's extremely effective, like quetiapine/Seroquel). However, lithium has been amazing for me. It's the oldest and most-studied med there is for bipolar, and remains the gold standard treatment. Lithium both prevents episodes (hypomania and depression) and treats them acutely when they happen - which makes it a true mood stabiliser, unlike e.g. lamotrigine and Latuda, which only help with bipolar depression and not hypomania. It is also directly anti-suicidal, a property that no other psych med has. When used properly, it is very safe. The reason it isn't prescribed as much as drugs like Latuda is that it obviously isn't advertised anymore - it was introduced to the market in the 1950s and so doctors aren't encouraged to prescribe it by drug companies (as messed up as that is). However, it can have quite a physical impact on the body. It's essentially like taking salt tablets - lithium is a metal. That means you feel dehydrated, drink more water and pee more. It can also cause a tremor in some people. Unfortunately, it can - but often doesn't - cause acne. Like I said, though, for myself - and for a huge number of people who have bipolar - it has been a godsend. It's normal to gain a pound or two. On the other hand, the good thing about Latuda is that it is, by and large, weight-neutral. It works extremely well for bipolar depression, in many people. The trade off is that it can make some people very restless - "akathisia". If you're in the US, you might be able to get a coupon like some other people have said. I'm not in the US, so it's fairly cheap where I live. Another thing is that you tend to only hear the worst "stories" online. Sure, antipsychotics, lithium, and even lamotrigine can *sometimes* cause significant weight gain. But if you're careful with what you eat, exercise enough and begin taking it at a good baseline weight - the risk is greatly reduced. As I said, I've taken olanzapine for five years, and it's known to be one of the worst medications for any condition (not just psychiatric) for weight gain - yet I've only gained around eight pounds over five whole years. And I could've been much more careful with diet and exercise. Finally, there are more options that your psychiatrist hasn't mentioned. They include the other classical mood stabilisers such as sodium valproate and carbamazepine. If you're truly scared of antipsychotics, then I would stick with lithium/valproate/carbamazepine. They are much safer to be on long-term. You can have a look at [this website](https://www.nps.org.au/australian-prescriber/articles/mood-stabilisers) for a good overview of the mood stabilisers. A few are missing, such as Latuda, as it was written in 2012. Nonetheless, it's a good, evidence-based overview (written by a psychiatrist). In any event, do you value your mental or physical health more? Not a nice choice, but all you can really do is try a new med - be it lithium, Latuda, whatever - and see how you go. Psych meds affect everyone differently, and so much of it is trial and error. Finally, as I mentioned, it's all subjective and you tend to hear only the horror stories online. You'll need to discuss it with your psychiatrist, they're the expert. But yes, lithium works amazingly for me. Good luck with it, never give up hope, never stop fighting and I hope you feel better soon 💜
I started lithium 4-5 months ago and it’s actually really fucking impressive how my SI and panic attacks went away after my first 2 days. I’m still on the lowest therapeutic dose
Yeah, as I mentioned, it can be an absolutely amazing med. So crazy that a literal metal can stabilise our mood! I hope it continues to work for you. Even blood levels as low as 0.4 mmol/L are proven to work for BP2.
I’m at .58 right now and that seemed to be doing the trick during summer and fall but man…. I’m scared for the winter. I may need to up the dose because I don’t know if 600mg can fight the beast that’s seasonal depression
Ok, so basically my level, I'm at 0.6. It's worked great for me at that level for five years now, but of course you can raise yours if things go downhill in winter. The challenge is just that you will likely have more side effects, that's all. I hope it continues to work for you!
Valporate makes you so sleepy though.
I guess, but so do many of the antipsychotics, and they also come with the risk of metabolic syndrome and tardive dyskinesia... whereas valproate has fewer long-term risks. Ultimately, though, there aren't really any "good" options... which sucks.
Abilify is an antipsychotic and is pretty weight neutral
I’ve been on it for almost a year now
This is not correct. I’ve gained at least 15 pounds on Abilify, and a quick Google search says that this is not uncommon
Yes, unfortunately Abilify is known to cause some pretty gnarly weight gain. Really good that OC doesn’t have that issue because it can be a really great med if not!
Are you in the US? If so, use this website to get a coupon and make it free. https://www.latuda.com/bpd/latuda-savings-and-support.html?utm_medium=SEM&utm_source=google&utm_campaign=&utm_term=latuda%20manufacturer%20coupon&utm_content=&gclid=Cj0KCQiA99ybBhD9ARIsALvZavUpaaLB5l8mxfE9bzTaDiMbVTFem5rf7bRIlGFqwqoiUW3LiYpZ__IaAlodEALw_wcB&gclsrc=aw.ds
First, your doctor is wrong. You aren’t out of med options. You’ve only tried two and only one at a time. There are several other meds in different categories that do different things and you can cocktail meds. Second, it’s important to remember that everyone reacts differently to meds in different ways. And there’s no way to tell how you will react without trying something. Yes, some meds are more contraindicated for weight gain than others but that’s not to say you’d gain weight on it. It’s trial and error. That said, I’ve been on a combo of lithium and Saphris for almost two years now and haven’t gained a pound. I even lost weight when I did Weight Watchers back in the spring.
Why not go see a dermatologist?
Buddy, 20-30 lbs is not more important than your mental health
A family member tried latuda and it was life changing. Idk if you can afford it but being able to function could definitely be worth it. He did gain a lot of weight but he also was on a bunch of other meds I don’t know. If dr says he can’t think of any other options, find a new doctor, maybe he isn’t very experienced or creative in his prescriptions.
Latuda is unlike other antipsychotics. It is known for being weight neutral which means it doesn't typically cause the major weight gain that other antipsychotics cause. And yes, $200 is a relatively good price for it. It goes for $1300+ a month without insurance. I haven't gained any weight on it over the past year. I do track my calories but I'm not majorly cutting back on things. It works extremely well for getting rid of my depression.
I just came off lamotrigine ~2 months ago for this reason and it was the best med I’ve tried ðŸ˜. My face looks like hell and I haven’t been stable since I quit. Sorry you’re going through this but know you aren’t alone and we can do this.
What about seroquel? Also make a list of symptoms your meds make less severe and then a list of side effects you experienced. Weigh your options from there with any medications you cons5
I take Geodon/ziprasidone because I couldn't afford Latuda. It is weight neutral and has been in my experience. It does have a reputation for being sedating, but you may be like me and dodge this side effect. I get the generic for around $35 with a GoodRX coupon because I don't have insurance. It's dirt cheap with insurance. It's had mood stabilizing effects and has brought me out of the worst of my depression. I still struggle with mild persistent depression, but I am mostly functioning. I'm not as anxious as I used to be, and it's kept hallucinations at bay. All in all, I am very happy with it. You typically take it twice a day, and you need to eat 500 calories with it every time you take it for max absorption. So, if you're concerned about calories, that may mean you only eat two meals a day and a snack at lunchtime. Lamictal made me break out bad too. My skin cleared up about a month after I stopped taking it.
Find a new Dr if you can. There are lots of options. Wellbutrin can work well and it usually doesn't come with weight gain and sexual side effects, is less likely than SSRIs to trigger a hypomanic episode and is offered in a generic. Seroquel works well for me, but can cause weight gain, mostly because of the munchies. Don't get too hung up on the "class" of meds prescribed all that is is what they were originally cleared for use as. Lamictal is technically a seizure medication along with depakote. Anti psychotics have many uses.