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Metformin or switching drugs for AAP weight loss?


frog
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Hi all,

I'm at my wit's end due to weight gain from Seroquel (that I take as a bipolar mood stabilizer). I've been on it since 2006, and have gained 70 lbs, about 50 lbs above baseline. That puts me at 5'6" and 211 lbs. I don't eat like a pig, yet I keep getting bigger, unless I really restrict myself, and then my weight just stays stable until I let myself go again. Before the Seroquel, I had a baseline weight of about 165, even though I didn't eat perfectly.

I feel ugly and horrible about this, especially worried that I'll get diabetes in the next few years (I'm 36). My doctor has suggested we start me on metformin because it's been shown to reverse AAP-related weight gain, and I'm considering it. BUT the studies I've read don't really impress me. I mean, losing 10 lbs? That's it? Is that really worth it? That's not really fixing the problem, is it?

Has anyone here had success losing more than a tiny amount of weight with metformin? If not, what strategies did you use? Was it even possible to lose weight on Seroquel? (My experience says only with a low-carb diet, but that rebounded terribly when I went off the diet. Lost 25 lbs, gained 35 back.) Did you have to switch meds? (I've tried so many, and so far Seroquel is the only mood stabilizer I can tolerate.) Which ones are weight-neutral and also have anti-manic/mood stabilizing properties?

FYI I have Bipolar 1 with manic episodes every 2 years or so (give or take half a year), then depression, followed by stability for some time, sometimes years. I've already tried and not had success with Geodon, risperidone, Lamictal, lithium and valproate, either due to them not working or the side effects. At one point I was also on Wellbutrin with the Seroquel, but it caused me more frequent manias.

Thanks,

frog

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I to am on Seroquel and have been on Metformin for a few years.

I haven't lost any weight, but I haven't gained any.

I like taking metformin just as a pre-diabetes protectant, even if it does that at all.

 

Seroquel has made my life worth living so I kind of have to accept the weight gain. Better to be chunky than crazy.

 

Metformin can't hurt, right?

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I will warn you.  You will probably get diabetes.  Seroquel has been shown to raise blood sugar levels, cause insulin resistance and about 1/3 of people taking Seroquel develope diabetes.

You probably should have have a fasting blood glucose level test to see if you arent pre-diabetic.

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The OP said that the person had gained 70 lbs after starting Seroquel.  Weight gain which is a side effect of Seroquel is a big risk factor in developing diabetes.  Further, the maker of Seroquel knew about the weight gain and diabetes risk quite early on - and hide it.  A study of 30,000 veterans (I believe that was the population size) on Seroquel showed that there was a clear correlation/causation between Seroquel and diabetes.  The government - the FDR - ordered the drug maker to send out a "doctors' letter" informing all doctors that Seroquel carried a high risk of causing diabetes.

I post more information on this in the next post

A quick Google search  

Side Effects of Seroquel

Like other antipsychotic medications, Seroquel has numerous side effects. Some of the more serious effects include the following:

  • diabetes and high blood sugar
  • neuroleptic malignant syndrome (NMS) -- a life-threatening condition which causes fever, stiff muscles, irregular or fast heartbeat, change in blood pressure, problems with kidneys, and confusion, and
  • tardive dyskinesia (TDI) -- a neurological disorder that causes involuntary movement of the face and body.
Edited by Ralphmi
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The OP said that the person had gained 70 lbs after starting Seroquel.  Weight gain which is a side effect of Seroquel is a big risk factor in developing diabetes.  Further, the maker of Seroquel knew about the weight gain and diabetes risk quite early on - and hide it.  A study of 30,000 veterans (I believe that was the population size) on Seroquel showed that there was a clear correlation/causation between Seroquel and diabetes.  The government - the FDR - ordered the drug maker to send out a "doctors' letter" informing all doctors that Seroquel carried a high risk of causing diabetes.

I post more information on this in the next post

A quick Google search  

I should have specified. Peer reviewed info is what is needed for a citation. The first link you posted is anecdotal. It is apparently a lot of people that say yes, it can cause diabetes followed by some that say it doesn't. While anecdotal information is certainly interesting, it doesn't necessarily hold true for anyone but the person making the comments.

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The OP post is a prime candidate for diabetes. That is a fact.  Taking Seroquel and having large weight gain.  OP should be tested for high glucose levels and prediabetes.  

It would be irresponsible, totally irresponsible, not to inform OP of this.

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Just to get a bit back to the original topic-I took Seroquel XR and gained 25 pounds on it, and had to go off it to lose any weight at all. The IR in small doses, as for sleep, never affected my weight, but the XR was a killer. I've been off of it for two months and have lost about four pounds. My pdoc didn't want to put me on metformin because she said my blood work didn't indicate it. But my weight crept steadily upward the whole time I was on Seroquel XR.

Edited by Gearhead
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The OP post is a prime candidate for diabetes. That is a fact.  Taking Seroquel and having large weight gain.  OP should be tested for high glucose levels and prediabetes.  

It would be irresponsible, totally irresponsible, not to inform OP of this.

You are not the OPs doctor. It is up to the prescribing doctor to advise the OP about any potential side effects. 

There is a huge difference between 33% and 66%. 

An A1C would be a reasonable test that would let the OP know if they're leaning towards diabetes or not.

You much faith in doctors...........

Nobody here is a Doctor.  So perhaps No One is qualified to comment on any medicines or any of their side effects.  Not even you.  You are not qualified to judge whether 33% is a high or low number for a serious side effect. You are just guessing.  (It is a high number, because AstraZeneca has been sued for harmfull effects and paid out over $500 million in settlement costs.)

I am surpised you are unaware of any of this.  The Seroquel lawsuits against AstraZeneca have been in the NYTIMES and Wall Street Journal and many other places.

So only Doctors can comment on drugs?

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So... if NOBODY here is a doctor, why is anyone speculating about a diabetes diagnosis for someone whose life may be so short from mental illness that diabetes won't matter?

Seroquel does have specific risks, as do ALL medications.

It's up to the OP and their prescriber to weigh out the risks and benefits of any treatment approach.

I will also tag on and say that I am genetically loaded for type 2 diabetes on BOTH sides of my family. And I gained about 40# while taking slurroquel.

HOWEVER, in all likelihood, I would have been dead had I not had slurroquel when I did, because my mental health symptoms were FAR worse than the risk of developing diabetes at that point.

In the intervening years, I have gotten more stable with regard to my mental health, have no indicators of being prediabetic, and have lost a significant portion of the weight I gained while on slurroquel through keeping track of my food and exercise.

OP, all the research I looked at said AAP-induced/associated weight gain was best addressed by either food logs or metform plus food logs. Not sure if that's helpful. But it's what I found when I looked a couple years ago.

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I have been afraid of developing diabetes, which is a big reason I want to be on a different med and lose weight. (Or metformin - but that is not sounding very promising.)

I get regular blood tests for fasting glucose and hemoglobin A1C, and so far my blood tests have been healthy. No pre-diabetes. But both my mother and father developed Type II diabetes in their 40s, and I'm already 36, so I feel that the Seroquel and weight gain combined with family history puts me at risk. I'm concerned that eventually my blood tests won't be healthy.

At this point I think switching to another med would be preferable to trying metformin, but unfortunately I'm running out of weight-neutral meds to try. At the moment I'm contemplating asking my doctor about Tegretol, as I've never tried it before. I've already tried Geodon, and it was a disaster. Same for Haldol. Lamotrigine helps with depression but not mania. Lithium is not particularly weight neutral, and last time I was on it I felt depressed and flat, and my thyroid was starting to have problems. Divalproex is also not weight neutral, and it caused me to feel all panicky when I tried it. Risperdal gave me akathisia. Never tried Abilify, but I hear it causes a lot of akathisia, and is not necessarily weight neutral. Olanzapine (Zyprexa) caused massive hunger and rapid weight gain.

I need something strong enough to prevent full-blown mania. So what does that leave me to try? Anything other than Tegretol?

frog

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I need something strong enough to prevent full-blown mania

Sometimes no med is strong enough to prevent full-blown mania ALL of the time.  A lot of the time, IMO, the meds might might lessen the number of manias, but don't get rid of them completely.

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