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Dr. Bob is Robert Hsiung, MD,
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Posted by Fivefires on June 22, 2007, at 4:32:25
In reply to Re: Alli (Melts away fat?) » Fivefires, posted by JAy_BrAvESt_fAcE on June 21, 2007, at 20:39:38
Don't know Zenical JAy.(?)
Posted by Fivefires on June 22, 2007, at 6:00:31
In reply to Re: Alli (Melts away fat?), posted by Phillipa on June 21, 2007, at 13:57:27
Big boo-boo ~ erased my well-written(?) post! Now, what was I babbling on about?
Okay, Zenical and Alli, yes, see they are much alike, Jay.
Yes Phillipa I love cuddling too, but I love 'orgasms' because they 'unclog my brain'!
Seems Metformin is the preferred adjunct to the EPS of weight gain from atypicals and mood stabilizers at this time. Right?
I've written down clozapine (Seroquel) has the least EPS (extrapyramidal side effects), i.e. weight gain. And, second to it, is Quetiapine (Zyprexa).
Why have I written here something about Seroquel being buffered with Zyprexa??? :(
Will someone w/ a working brain tell me what I forgot and can't find now?
I'm not sleeping (I don't think so anyway.) and this is 'totally new' for me. It is the mid of night.
I was on Provigil for a couple months and think discontinuing it disrupted sleep rhythm. At same time I was getting a lot of non-supportive badput from those I love the most, my family. They wanted me to 'go away'. I said 'well where do you want me to go? Shall I just walk off into the sunset? Doesn't anyone want me anymore or love me anymore? Am I being 'outed'? Will I meet Mel Gibson and be saved?
RU guys over on the East coast awake yet?
I remain on 2mg Xanax 3x a day and no other psych med. I'm not doing well. ADs increase what is now just shallow 'ideation' so P wants to stay away from them. But, my PCP keeps pushing me to try Effexor-XR's pal. I'm in and out of bed all day. Yet, 'the actress in me' can walk out the door looking like I don't have an illness or problem in the world.(?) I've been practicing for a few decades!
I'd like to see a discussion of the issue of weight gain due to pysch meds continue here. I hope it will.
TAKE CARE ALL
5f
Posted by Racer on June 22, 2007, at 13:31:03
In reply to Alli, Zenical, Metformin - 'Down in front!', posted by Fivefires on June 22, 2007, at 6:00:31
>
>
> I've written down clozapine (Seroquel) has the least EPS (extrapyramidal side effects), i.e. weight gain. And, second to it, is Quetiapine (Zyprexa).
>Sorry, I want to make two corrections:
Quetiapine is Seroquel, clozapine is Clozaril. Zyprexa is olanzapine.
And extrapyramidal side effects are actually things like tremor, slurred speech, akathesia, dystonia, anxiety, paranoia, and slowed/impaired thought processes. I don't think weight gain is considered an EPS. (I'm sure someone will correct me if I'm wrong about that.)
Doctors are FINALLY starting to take weight gain seriously, though. It's taken a while, and there's still a limit to what they can do to help, but at least a significant number of them are taking it seriously and working with their patients to mitigate the problem when it occurs.
OK, I'm done...
Good luck.
Posted by KayeBaby on June 22, 2007, at 13:37:28
In reply to Alli, Zenical, Metformin - 'Down in front!', posted by Fivefires on June 22, 2007, at 6:00:31
>Yet, 'the actress in me' can walk out the door looking like I don't have an illness or problem in the world.(?) I've been practicing for a few decades!
I need some lessons! I am an open book. One glance at me will tell you all you need to know and if you hang around a minute I'll bore ya to death with my griping.
Kaye
Posted by kaleidoscope on June 22, 2007, at 14:14:17
In reply to Alli (Melts away fat?), posted by Fivefires on June 21, 2007, at 12:22:01
Hi
Alli and Xenical are the same drug. Alli capsules contain orlistat 60mg. Xenical caps contain orlistat 120mg. Both products are taken three times a day with meals.
Orlistat works by reducing the absorption of fat from the intestine. The most common side effect is diarrhoea/loose oily feces.
Posted by Zyprexa on June 22, 2007, at 14:22:34
In reply to Re: Alli, Zenical, Metformin - 'Down in front!' » Fivefires, posted by Racer on June 22, 2007, at 13:31:03
How do they prevent the weight from going on, or to get it off? Besides controling the blood sugar? Diet pills?
Posted by LlurpsieNoodle on June 22, 2007, at 15:36:42
In reply to Re: Alli (Melts away fat?), posted by Fivefires on June 22, 2007, at 4:32:25
Hi Fivefires,
I think that the sticker price on Alli is pretty expensive. If you have good Rx coverage and want to try this med, get an Rx, that way it won't come out of your pocket (as much)Any psychmed (or med in general) is only effective if the patient will eat it. You have every right to inform your pdoc about which side effects are unacceptable.
My pdoc heard me loud and clear when I told him that I had gained so much weight on qetiapine (or however seroquel is spelled). a perfect storm. holidays and seroquel (300mg, btw). I swear, I ate 6 pieces of pie after humonguous thanksgiving dinner.
sigh...
metformin may have fewer side effects than Alli? not sure if you have typeIIdiabetes symptoms.
hugs,
Ll
Posted by Cecilia on June 22, 2007, at 19:33:21
In reply to Alli (Melts away fat?), posted by Fivefires on June 21, 2007, at 12:22:01
Jay Leno spoke on the Tonight Show about Alli--how the company's own web site recommended wearing dark clothes and always carrying an extra pair of pants with you! Gross. I suppose it might make you lose a little if the side effects make you avoid fatty foods or you stay home all the time and wear Depends. Cecilia
Posted by Racer on June 22, 2007, at 19:47:54
In reply to Racer, what are they doing for weight gain??? » Racer, posted by Zyprexa on June 22, 2007, at 14:22:34
> How do they prevent the weight from going on, or to get it off? Besides controling the blood sugar? Diet pills?
Well, for the most part it seems to be a question of reversing the weight gain, rather than preventing it. At least, according to the few things I've read. There are several drugs offered, which help. Metformin, Topomax, Zelnorm (which has now been taken off the market), stimulants, Wellbutrin, etc. Some doctors are willing to start something as soon as you notice some weight gain. Others, of course -- well, it can feel quite satisfying to fire a pdoc!
The best news, really, isn't so much that they've found ways to fix the problem. They've found ways to mitigate it, to improve the situation, but not a perfect fix that I've seen. The best news really is just that doctors are recognizing that the weight gain is real, the meds really do cause it, and that patients really aren't eating all the way through a pastry shop daily to gain the weight. Just the fact that more doctors are believing it, and fewer are telling patients it's our own fault.
My very first pdoc, when I complained about gaining approximately 60 pounds on nortriptyline in fewer than six months, told me I needed to eat less. She said it had nothing to do with the drug. Told me to eat lower calorie, lower fat foods. I was anorexic! Half the time, I was trying not to eat AT ALL because I couldn't stand the weight gain. An average day's food was far less than a single healthy meal. But she insisted it was my fault for eating too much, and I had to learn to control myself around food... While my severe depression may have been reversed, the weight gain destroyed the little self-esteem I had at that point in my life. If fewer doctors are doing that, I consider it a sign of improvement.
Posted by Zyprexa on June 23, 2007, at 13:29:58
In reply to Re: Racer, what are they doing for weight gain???, posted by Racer on June 22, 2007, at 19:47:54
My doctor is suggesting this. but I worry about anti-diabetics and bad side-effects.
Posted by Racer on June 23, 2007, at 14:23:45
In reply to Re: Racer, *Metformin* for weight gain??? » Racer, posted by Zyprexa on June 23, 2007, at 13:29:58
> My doctor is suggesting this. but I worry about anti-diabetics and bad side-effects.
Well, see, there's some evidence that Zyprexa can cause problems with insulin resistance even in the absence of significant weight gain. That would suggest that metformin is a pretty good bet to counter the problem. In fact, I think that's pretty much standard of care these days, although I could be wrong....
What I do know, though, is that a lot of articles have come out in the past year or so, in a lot of journals, about the use of metformin to counter insulin resistance, weight gain, and metabolic syndrome associated with the use of second generation anti-psychotics. The consensus seems to be that it's a pretty darn good idea. The only entity which doesn't seem to like this idea is Lilly, but that's older information, and it's likely they don't want to imply that their drug could be linked to the development of diabetes.
It sounds as though you have some objections to trying it? I'm only curious -- I'm the last person to say, "Ah, just take it..." since I tend to freak out pretty completely at the thought of any med changes. What sorts of things are you worried about with it? Do you think it's worth giving it a try?
OH! Another thing you could try, in the meantime, are H2 blockers like Pepcid, Axid, Zantac, etc. Apparently the benefit is limited to reducing appetite, and tends to wear off after about four months, but it's still worth giving it a try.
I hope that helps.
Posted by Zyprexa on June 23, 2007, at 14:47:14
In reply to Re: Racer, *Metformin* for weight gain???, posted by Racer on June 23, 2007, at 14:23:45
Yes! helps a lot. I am seriously considering Metformin as I was supicious about the insulin thing. Only thing I worry about are side effects from Metformin, what do you know about this, like acidosis and lymp fluid problems, I know they are very rare, but deadly. Probably I will get a script for it next week, as metformin was the best looking AntiDiabetic and cheep as hell..
Oh, and I do take glycine 30mg, which has a great effect of lowering blood sugar levels, and alowing me to eat more. but I'm still about 20 lbs over weight. And guess what!, both of my brothers are 40 lbs lighter than me and 2" taller, but when I sit and eat at the table with them, the quantities on there plates are deffinitly much bigger than mine, Its quite upsetting as I'm not the type to eat between meals and they are, the age difference is not that great, and they are 40lbs lighter and much healthyer.
Zyprexa:(...
Posted by Zyprexa on June 23, 2007, at 14:50:41
In reply to Re: Racer, *Metformin* for weight gain???, posted by Racer on June 23, 2007, at 14:23:45
How quick does the fast acting metformin kick in? One hour? Thanks Zyprexa.
Posted by polarbear206 on June 25, 2007, at 9:44:28
In reply to Re: Racer, what are they doing for weight gain???, posted by Racer on June 22, 2007, at 19:47:54
There is info at psycheducation.org about the use of Metformin for insulin resistance and weight gain with psychotrophic medications. There are only a few antidiabetics on the market that can cause weight loss and Metformin is one of them. I think it is reccomended 1000mg daily in divided doses, provided you eat 6 small meals a day, I would think it should have minimal side effects if any. It seems to be more promising for adolescents from what I gather.
Polarbear
Posted by Sigismund on June 26, 2007, at 15:45:03
In reply to Re: Racer, what are they doing for weight gain???, posted by polarbear206 on June 25, 2007, at 9:44:28
Here is a link with stuff about doseage too.
Posted by Zyprexa on June 27, 2007, at 11:47:51
In reply to Re: Racer, what are they doing for weight gain???, posted by Sigismund on June 26, 2007, at 15:45:03
Thanks, that was very helpfull. My pdoc wants me to take it. But gp does not, with no reason. But suggests some of the newer ones, like actos and avandia? I'm more inclined to belive a .org.
Posted by Paulbwell on June 27, 2007, at 16:03:32
In reply to Re: Racer, what are they doing for weight gain???, posted by Racer on June 22, 2007, at 19:47:54
I have gained up to 10kgs in one month on some meds, Imipramine, Paxil.
ATM i'm a thin 62kgs (133 pounds) and am a six feet tall man, no doubt thanks to the 'mild stimulant'i'm hooked on, my metabolism, and food choices.
Meds certainly play a huge role, look at the obesity Zyprexia causes.
I spoke with a nurse a while ago, aged 62, nursing since 1965. She recalls a collegue who took methadrine tabs to loose weight-she did, unfortunately she also lost her mind.
Posted by Fivefires on June 27, 2007, at 19:24:46
In reply to Re: Racer, *Metformin* for weight gain??? More!, posted by Zyprexa on June 23, 2007, at 14:50:41
Feel like I could respond to every post in this thread, not because my input is needed, but rather because it's so interesting watching an important issue being discussed.
I'm not sure if I said anything here about seeing an older, new to me, Pdoc today, but I did.
He had never heard of 'Metformin, a medication used alongside an atypical antipsychotic to help prevent weight gain'. What are between the apostrophes are my words to him.
He said, 'Meds don't cause weight gain. The appetite may be stimulated, but it is the patients who eat incorrectly'. :{
I also asked him if he was familiar w/ selective serotonin reuptake 'enhancers' v. 'inhibitors', and he'd never heard of them(?) and acted confused about the concept, so I got confused too, and said no more about it!? (I hate it when that happens!)
Apparently he's the oldest Pdoc here in the county! (Do they just 'stop learning' or what?)
W/o any options I’d dreamed might have been offered to me today, I ordered up ‘another AD’. I'll give Cymbalta a try. I'm just takin' the scrip and moseying on back to my other, younger, Pdoc.
If we keep talking about dissatisfaction with weight gain, maybe things will change.
In meantime, those of u, like u Zyprexa, pls keep me (or us ?) informed as to your well-being should u begin Metformin. Of course ‘all possible bad side effects' s*ck, so I know you'll keep in close contact w/ Pdoc, PCP, but here too please.
I'd try it, if I had the opportunity to do so.
I think I'm going through one of my 'rock the boat' periods. Is anyone picking up on this?
There's a thread about some improper Yiddish slang which pretty much sums me up. I think I’m a bit of a troublemaker. I truly ‘don't rock boats' to cause trouble. My intention is to cause change.
I'm not reading the side effects of Cymbalta, but will reach for phone should I need and appreciate you here for me. I need to get out of a bad depressive state, hindered by treatment resistance, but won't go w/ an atypical antipsychotic w/o its side effect of weight gain being managed somehow. So, it’s back to another AD for me. I have a c-spine injury, so maybe, like the commercial, Cymbalta will turn out to have been good for me. Won’t know till probably a week after begin tomorrow.
5f
ps: Racer - Why are there asterisks around the medication in the subject line? Is this a rule thing? Tks.
Posted by Zyprexa on June 27, 2007, at 20:38:09
In reply to Re: Racer, *Metformin* for weight gain??? More!, posted by Fivefires on June 27, 2007, at 19:24:46
Posted by Zyprexa on June 28, 2007, at 13:44:54
In reply to Re: Racer, *Metformin* for weight gain??? More!, posted by Fivefires on June 27, 2007, at 19:24:46
Thought I would mention this. Glycine, I'm also taking which does a great job of lowering blood sugar. Only thing is it does not much for weight. I'm hoping the Metformin will help with this. Starting 500mg metformin with breakfast. After 2 weeks take the other 500mg with supper. I took the first dose this morning and not adverse effects what so ever. The glycine I'm taking about 7.5grams 4 times a day, with meal. Glycine is otc and has only side effect of calming and mildly sedating.
Posted by Fivefires on June 29, 2007, at 11:26:14
In reply to Glycine, posted by Zyprexa on June 28, 2007, at 13:44:54
I just erased a long response .. dang it.
It began w/ my saying I'm not diabetic.
I then mentioned my TRD and I've only not been on Cymbalta and MAOIs, so that's why trying Cymbalta.
There's an article in Elle July about peeps w/ TRD being treated w/ narcotics i.e. Vicodin, and the article speaks of a doc that believes this to be true, although he is more interested in 'reopening MAOIs for a closer look'. It was really interesting, but I couldn't afford it. Maybe will still be on rack first week July.
I need to tell u all something, as u might wonder why I am so interested in an atypical antipsychotic. That is what Seroquel is, right? It is used for bipolar, psychosis, and depression, right?
Ok. When had nervous system breakdown, of course was given Valium and received great relief, but these two docs also gave me Seroquel. A week later when I was at home and still taking the Seroquel, I looked down at my stomach and starting laughing. I mean, I was feeling happy. I was laughing about my fat stomach. I called a friend and she laughed w/ me. She said 'see ... you shouldn't be on ADs ... you're mean when you're on them'. (I also have increased ideation on ADs.)
Unfortunately, the humor abated rather quickly. The tummy was getting bigger and bigger and I'm little. I stopped Seroquel. I lost the 'happy feeling and fat tummy', and started to look like me again.
Please don't judge me too harshly for caring to look nice as I am single again and not ready to 'just cuddle' ya know? Please understand.
Anyway, this is my reason for seeking whatever knowledge I can about something to take alongside, say, Seroquel, so as not to gain weight.
I don't know if the experience means I am bipolar. I know there are like a whole bunch of different types of biplar now.
They also had me on Trileptal, but it gave me a headache, as did Lamictal, and I don't think I was on one of those when I left the hospital, and upon getting home and laughing at my stomach!
So, please Zyprexa, would u keep me in your loop? I'm open to babblemail.
I don't really don't understand this whole blood sugar thing. I've always been able to eat a cow and not gain weight. I know; I'm spoiled. I've never been overweight.
So don't know much about it. Do we get alot of fat from sugars Zyprexa?
tks, 5f
Posted by polarbear206 on June 29, 2007, at 11:42:04
In reply to Re: Glycine, posted by Fivefires on June 29, 2007, at 11:26:14
> I just erased a long response .. dang it.
>
> It began w/ my saying I'm not diabetic.
>
> I then mentioned my TRD and I've only not been on Cymbalta and MAOIs, so that's why trying Cymbalta.
>
> There's an article in Elle July about peeps w/ TRD being treated w/ narcotics i.e. Vicodin, and the article speaks of a doc that believes this to be true, although he is more interested in 'reopening MAOIs for a closer look'. It was really interesting, but I couldn't afford it. Maybe will still be on rack first week July.
>
> I need to tell u all something, as u might wonder why I am so interested in an atypical antipsychotic. That is what Seroquel is, right? It is used for bipolar, psychosis, and depression, right?
>
> Ok. When had nervous system breakdown, of course was given Valium and received great relief, but these two docs also gave me Seroquel. A week later when I was at home and still taking the Seroquel, I looked down at my stomach and starting laughing. I mean, I was feeling happy. I was laughing about my fat stomach. I called a friend and she laughed w/ me. She said 'see ... you shouldn't be on ADs ... you're mean when you're on them'. (I also have increased ideation on ADs.)
>
> Unfortunately, the humor abated rather quickly. The tummy was getting bigger and bigger and I'm little. I stopped Seroquel. I lost the 'happy feeling and fat tummy', and started to look like me again.
>
> Please don't judge me too harshly for caring to look nice as I am single again and not ready to 'just cuddle' ya know? Please understand.
>
> Anyway, this is my reason for seeking whatever knowledge I can about something to take alongside, say, Seroquel, so as not to gain weight.
>
> I don't know if the experience means I am bipolar. I know there are like a whole bunch of different types of biplar now.
>
> They also had me on Trileptal, but it gave me a headache, as did Lamictal, and I don't think I was on one of those when I left the hospital, and upon getting home and laughing at my stomach!
>
> So, please Zyprexa, would u keep me in your loop? I'm open to babblemail.
>
> I don't really don't understand this whole blood sugar thing. I've always been able to eat a cow and not gain weight. I know; I'm spoiled. I've never been overweight.
>
> So don't know much about it. Do we get alot of fat from sugars Zyprexa?
>
> tks, 5f
>
>Have you considered to give Lamictal another try? This is the ONLY mood stabilizer that has not caused weight gain for me. I don't even know I am on a mood stabilizer. No blunted or cognitive side effects. Do you think you titrated the dose too quickly? Headaches are usually a common side effect during initial start-up and go away. There has been good results with others who got unwanted side-effects when they started, so they tried it again with slower or lower increases, and had good results.
Polarbear
Posted by Zyprexa on June 29, 2007, at 15:21:28
In reply to Re: Glycine, posted by Fivefires on June 29, 2007, at 11:26:14
Seem to be losing weight, so far 1 lb. Not gaining. Apatite is down.
Sugar makes you fat. The less you have in your blood the thiner you are. Carbs are sugar. Protein is very low in sugar and helps lose weight, while controling hunger better for longer times than sugar. You can eat a lot more protien than sugar and be a lot healthyer.
You can babble mail if you want.
Zyprexa
PS: Day 2 with metformin 500mg at breakfast. Going to try it at supper instead, because blood sugar is a little high in morning after a large carb breakfast. For some reason morning blood sugar is higher, even before I eat.
Posted by Zyprexa on June 29, 2007, at 15:32:56
In reply to Re: Metformin » Fivefires, posted by Zyprexa on June 29, 2007, at 15:21:28
Should mention that I started taking B-100 yesterday. Not sure but think this may be helping too.
I am also going to start 5000-10000mg biotin, which is a B-vitamine that can lower blood sugar 50%. I've also heard that B-vitamins can help weight loss.
Posted by Fivefires on June 29, 2007, at 21:23:58
In reply to Re: Glycine » Fivefires, posted by polarbear206 on June 29, 2007, at 11:42:04
Hey Polar Bear. I've always been bad about sticking out a bad side effect awaiting it to diminish, but will definitely keep Lamictal in mind to maybe try again.
tks, 5f
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