Do all bipolar medications cause weight gain?

Answers from Daniel K. Hall-Flavin, M.D.

Bipolar disorder can be treated with a number of medications. Some of these medications can increase your appetite or cause changes in metabolism leading to weight gain.

Whether a certain medication will cause weight gain or other side effects varies from person to person. Also, how well the medication works to treat bipolar disorder symptoms differs among individuals. Because of this, finding the medications that best treat your symptoms may require some trial and error.

Medications for bipolar disorders include mood stabilizers, antipsychotics and antidepressants.

  • Mood stabilizers used to treat bipolar disorder include lithium (Lithobid), valproic acid (Depakene), divalproex sodium (Depakote), carbamazepine (Tegretol, Equetro) and lamotrigine (Lamictal). All of these medications are known to increase the risk of weight gain except lamotrigine.
  • Mood-stabilizing antipsychotics commonly prescribed for bipolar disorder include olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), ziprasidone (Geodon), lurasidone (Latuda) and asenapine (Saphris). It appears that aripiprazole, lurasidone and ziprasidone are more weight neutral than the others, but that can vary from person to person. Some of these medications cause weight gain when taken alone, but many people need more than one medication to control symptoms.
  • Certain antidepressants for bipolar disorder may be more likely to cause weight gain than others, but this can vary from person to person. Talk with your psychiatric care provider if you have concerns.
  • Antidepressant-antipsychotic. The medication Symbyax combines the antidepressant fluoxetine and the antipsychotic olanzapine. It works as a depression treatment and a mood stabilizer. Symbyax is approved by the Food and Drug Administration specifically for the treatment of depressive episodes associated with bipolar I disorder.

Some weight gain may be inevitable when taking medications to control your bipolar symptoms. If weight gain is an issue, ask your psychiatric care provider for advice on strategies to manage it. Healthy eating, keeping physically active and getting psychological counseling (psychotherapy) can all help.

Continue to work with your provider to find the best way to keep your bipolar symptoms and your weight under control.

Feb. 25, 2015