Posted by Iansf on October 2, 2005, at 18:07:51
In reply to Re: Amantadine stabilizes weight, posted by Iansf on October 2, 2005, at 17:54:46
So far the only amantadine studies I've found indicate weight stabilization but not weight loss. HOWEVER, I did find the following on metformin, a drug usually used to treat diabetes. Read through to the end for some especially interesting info re mood disorders:
A possible new entry in the "antidote" group is Glucophage (metformin). We have much less experience with this medication in this role, but tons of experience with it overall -- it's been a standard medication for diabetes for years. It does not lower blood sugar directly, so lowering your blood sugar "too far" using this medication is not a problem. It directly reverses on of the possible ways that Depakote and Zyprexa cause weight gain, through something called "metabolic syndrome". Too bad Glucophage is a little tricky to use: it causes diarrhea in about 50% of people who take it, although if you start low enough and go up slowly enough you are much more likely to avoid this problem.
However, there is one small "open trial" (no control group) which showed that adding Glucophage to Zyprexa, or Depakote, or Risperidone, was enough to cause 15 of the 19 kids who had gained weight on those agents to start losing weight. In most of the kids it was a substantial and sustained weight loss. And there's perhaps -- just perhaps -- one more reason to think that this "antidote" strategy with Glucophage might be a good thing.
As you'll see in the "metabolic syndrome" story, there is a sliver of evidence (so far; this is just becoming an active area of research) that Glucophage could actually treat mood symptoms somewhat similar to what we see mood stabilizers do for mood. If this was true, then we'd have here a medication that not only could prevent and reverse metabolic syndrome, it might actually be a "treatment" itself for mood symptoms. So far it looks much easier to tolerate in the long run than topiramate. I've even had a patient improve on it and then able to stop the Glucophage, while staying on Depakote at a lower dose than originally caused her weight gain, without a return of weight gain. That would be a great trick if we can get this result frequently with this medication! But, be aware that this approach is almost completely unresearched, so your doctor virtually certain to be unaware of all this. Iif she/he is hesitant about considering this approach, because of the lack of research, be aware that such hesitation is generally wise position to be taking at this stage.Source: PsychEducation.org, website of Jim Phelps, M.D.
poster:Iansf
thread:560627
URL: http://www.dr-bob.org/babble/20050927/msgs/562032.html