PsychosisSaturday, June 4, 2011
Today’s post is another excerpt from “Best Weight: A Practical Guide to Office-Based Weight Management“, recently published by the Canadian Obesity Network.
This guide is meant for health professionals dealing with obese clients and is NOT a self-management tool or weight-loss program. However, I assume that even general readers may find some of this material of interest.
Symptoms suggestive of mania or psychosis need to be investigated and treated before initiating a weight-reduction strategy. Unfortunately, current pharmacotherapy for bipolar disorder (lithium, valproate, olanzapine) and many of the the newer antipsychotics (clozapine, olanzapine, quetiapine) can produce dramatic weight gains. This effect on body weight can exacerbate obesity-related illnesses and hinder compliance with antipsychotic treatment.
There has been some success using topiramate for bipolar and mood disorders both as an independent weight-neutral or even weight-negative mood stabilizer, and as an adjunct to other antipsychotics to decrease iatrogenic weight gain. Lamotrigine may also be considered as a mood stabilizer, and it too has been shown to be weight neutral.
Of all the novel antipsychotics, ziprasidone and aripiprazole have been reported to be nearly weight neutral.
© Copyright 2010 by Dr. Arya M. Sharma and Dr. Yoni Freedhoff. All rights reserved.
The opinions in this book are those of the authors and do not represent those of the Canadian Obesity Network.
Members of the Canadian Obesity Network can download Best Weight for free.