Quetiapine affects different gene types in different ways, which means that some users may face an immense increase in body mass while others may not find it changing at all. If sleep and diet qualities are well, and there are normal amounts of physical activity, a user will probably gain less than someone with high stress levels and poor sleep and diet quality. There seems to be a positive relationship between the duration of taking Seroquel and weight gain.
The amount of weight a person gains in the first 12 months is the highest , after which the rate of body mass increase significantly slows down. This is because the body gets used to the treatment. However, when the treatment is carried on for an extended period, it is more likely that the user will notice a significant body mass increase over time. If patients use Seroquel with other drugs , it is possible that they may interact and exaggerate Seroquel weight gain.
Some antidepressants , for example, have the side effect of body mass gain at similar rates to Quetiapine. It is advisable to consult a doctor regarding all the medications that one takes to ensure that this does not happen unless necessary. The doctor can then prescribe the correct antipsychotic drug that suits the patient considering their other medical intake.
Most medications have a dose-weight relationship, which implies that increasing the dosage will increase the amount of pounds the user gains. Theoretically, this makes sense because antipsychotics gain control of the brain and nervous system.
Increasing the dose should technically increase the control of the medication gains, so if the patient gains pounds on a low dosage, a higher dosage should make the gain even more significant. However, it is not true for Seroquel. Patients taking quetiapine are lucky because increasing the dosage has no apparent relationship with an increase in BMI.
That being said, it is still true that everyone has a different genetic makeup and is subject to different external conditions, which is why patients taking Quetiapine should still be cautious, consult a doctor and take the prescribed dosage.
Some patients may experience Seroquel weight loss after stopping the medication. Other studies and clinical trials show that Seroquel has a neutral effect on body mass and that the increase in mass is not linked with dosage. One such study analyzed patients treated with quetiapine as monotherapy with controlled and open-label extension trials. In the beginning, their weight was assessed using the BMI and then again after 18 months.
This test showed that no matter what the dose, Seroquel does not cause users to gain a lot. On the contrary, some patients with obesity were noted to have been losing weight on Seroquel during the month trial. It may be because antipsychotic patients are advised to refrain from excessive eating and introduce some physical activity in their routines.
The precise reason why antipsychotics lead to body mass gain has not yet been found, which is why there is also no sure shot way of protecting oneself from it. That being said, Seroquel weight gain is usually the result of a calorie imbalance where a person consumes more calories than they burn. Also, patients should find cheap and healthy alternatives for fast food. This is a form of schizophrenia in which psychotic symptoms e. The table shows the risk of weight gain with different antipsychotics.
However, weight change can differ greatly from person to person. With any antipsychotic, some people may gain a lot of weight, some a moderate amount and some may not gain any weight or actually lose some weight. Greater weight gain during the first month of antipsychotic treatment tends to predict greater weight gain in the longer term.
Antipsychotics can increase glucose sugar and lipid fat levels in the blood. The drugs that do this the most tend to be the same ones that cause the most weight gain. A person starting antipsychotic medication for the first time is likely to gain more weight than someone starting the same medication who has previously taken other antipsychotics. This is because weight will often have been put on with earlier antipsychotic treatment.
This corresponds to people being treated by early intervention teams in the UK. The extra energy or calories are stored as body fat. Many factors can affect this energy balance and lead to weight gain. The main way that antipsychotics cause weight gain is by stimulating appetite so that people feel hungry, eat more food and take in more calories. Some people taking antipsychotics report craving sweet or fatty food.
The regulation of appetite and food intake is extremely complex and is controlled by part of the brain called the hypothalamus. The hypothalamus integrates information it receives from other part of the brain and from hormones released from outside of the brain including fat adipose tissue and the gut.
These hormones include leptin and ghrelin but there are many others. Exactly how this complex system works and how antipsychotics disrupt it are not fully understood.
Neurotransmitter receptors in the brain seem to play a part, with evidence implicating the serotonin 5-HT2C and 5-HT1A receptors, histamine H1 receptor and dopamine D2 receptor among others. Antipsychotics differ in their ability to block these receptors and this partly explains their different liability to cause weight gain. Both olanzapine and clozapine, drugs with a high risk of weight gain, bind strongly to the histamine H1 and serotonin 5-HT2C receptors. The pharmacology of antipsychotics is not the only factor that determines their effect on weight.
As already mentioned, if a group of people take the same antipsychotic there will be differences between them in their subsequent weight change. This reflects differences between people in their diet, level of activity and genetic makeup. Variations polymorphisms in a large number of genes, including the gene that codes for the 5-HT2C receptor, have been linked to susceptibility to gain weight with antipsychotics. It is the combined effect of these genes, rather that variation in a single gene, that is relevant to weight gain.
In the future, it may be possible to conduct a simple blood test i. This could help people choose the best drug for their treatment. However, such a test is not currently available. Decisions on choosing medication and managing weight, as with other areas of treatment, should be made jointly by a patient and their doctor.
The main approaches to managing weight with antipsychotics are:. Other approaches can sometimes help manage weight gain including adding certain medications to antipsychotics. These approaches are reviewed in a recent BAP Guideline that also considers the broader issue of reducing the risk of cardiovascular disease i.
Some people may consider stopping antipsychotic treatment due to weight gain. The issue of how long to continue antipsychotic treatment is complex.
Space only allows some basic comments to be made here. Excess weight caused by an antipsychotic will usually be lost gradually after medication is stopped. Weight put on for other reasons is likely to remain. The downside of stopping antipsychotics is an increased risk of becoming unwell, especially for people with schizophrenia and bipolar disorder. Sometimes relapse occurs suddenly with serious repercussions. A person should never stop their antipsychotic, or alter the dose, without discussing this first with their psychiatrist.
Together, the patient and doctor should carefully consider the advantages and disadvantages of continuing medication, stopping medication and other options for managing mental health, weight gain and other side effects. These will differ from person to person and reflect their medical history and current circumstances. The discussion should lead to a jointly agreed management plan that is tailored to the individual.
For some people stopping medication is a realistic option but for others it is inappropriate. If a decision is made to stop antipsychotic treatment, then the dose should be reduced gradually. Medication should not be stopped suddenly. A healthcare professional should monitor the person for signs and symptoms of relapse while the dose is reduced and after it is stopped.
For people with schizophrenia or psychosis, monitoring is recommended for at least two years after antipsychotics are stopped. A great deal of research is trying to improve outcomes for people with mental health problems. This includes developing more effective medications with a lower risk of weight gain and other side effects. Lifestyle modification programmes have a modest benefit in reducing weight gain in people starting antipsychotics and helping those established on antipsychotics to lose weight.
These interventions can be given to individuals or to groups or both approaches can be combined. Participants were encouraged to eat a healthier diet and spend at least 25 minutes per day doing moderate activity. If psychosis, at least in some people, could be treated by giving antipsychotics for shorter periods than is current practice then it would reduce weight gain and other medication side effects. The RADAR trial is an ongoing randomised trial in the UK that compares a gradual and supported programme of antipsychotic reduction to maintenance antipsychotic treatment i.
This approach has the advantage of avoiding antipsychotic side effects altogether. This work is at an early stage and at the time of writing its effectiveness is not known, though initial results are promising. Nevertheless, it would widen treatment choice for some people and represent a major step forward in treating psychosis. Antipsychotics are effective in treating schizophrenia and mania but can cause a range of side effects. Weight gain is a common and serious side effect, especially due to its impact on physical health.
Various interventions can help and a psychiatrist will be able to offer advice on these. Many people taking antipsychotics can lose some weight with simple changes to their diet and lifestyle.
Losing even a small amount of weight can have important health benefits. Ongoing research is attempting to find ways to better manage or ideally avoid this problem. The BAP Guidelines on the management of weight gain, metabolic disturbances and cardiovascular risk associated with psychosis and antipsychotic drug treatment are available at: www. An article reviewing these Guidelines is available at: www.
Eur Psychiatry 24 6 BAP guidelines on the management of weight gain, metabolic disturbances and cardiovascular risk associated with psychosis and antipsychotic drug treatment. J Psychopharmacol 30 8 Efficacy and tolerability of olanzapine, quetiapine, and risperidone in the treatment of early psychosis: a randomized, double-blind week comparison. Am J Psychiatry 7 N Engl J Med Last updated: March PLoS One 9 12 : e The STRIDE weight loss and lifestyle intervention for individuals taking antipsychotic medications: a randomized trial.
Am J Psychiatry 1 Diabetes Care 34 7 : — Trials Cognitive therapy for people with schizophrenia spectrum disorders not taking antipsychotic drugs: a single-blind randomised controlled trial. The Lancet , My Sons weight more than doubled in the 5 years that he took Clozapine.
But there is hope. Many medications used in the treatment of mood disorders list weight gain as a potential side effect, including:. A presentation by Dr. Ganguli began by saying he had treated many psychiatric patients for years without really thinking about their weight.
Rohan Ganguli said that, unfortunately, "it has been assumed that people with schizophrenia are socially unaware and that, unlike the rest of us, [their weight] really does not matter to them. Ganguli and his fellows developed a program that clinicians could easily provide to their patients. It involved 14 weeks of group sessions with training in areas including developing healthy eating habits , burning more calories, and changing snacking habits.
Self-monitoring in the form of daily weighing and food and exercise logs was key. In addition to promoting key lifestyle changes in a supportive, collaborative environment, the program also focused on counteracting common thoughts, such as those surrounding the concept of "wasting" food.
A key part of the program's strategy was teaching people that it was OK not to eat the entire meal. Finally, they tested the program with patients who were just starting on some of the medications that are known to cause weight gain, including Seroquel quetiapine , Risperdal risperidone , Clozaril clozapine , and Zyprexa olanzapine.
In all cases, intervention prevented weight gain in more patients than in the control group, although the success rate depended on the medication. A unique set of challenges exists for those with psychiatric disorders that might not in other populations, including the metabolic effects of their medications, the impact of symptoms on motivation, poor dietary habits, and high rates of sedentary behavior. For example, Ganguli and his team found that many people with schizophrenia eat at fast-food restaurants because these are inexpensive and convenient, but these meals are often high in calories and low in nutritional value.
Chronic poverty can also be a factor for those with mental illness, which affects the quality of life, self-esteem, and the ability to pursue "leisure" activities such as participating in exercise. A meta-analysis of 17 studies and nearly 2, participants looked at successful lifestyle interventions for those living with serious mental illness. The study found that programs of at least a year's duration had more consistent outcomes.
Some of these interventions included physical activity, nutritional advice, behavioral programs, and access to free fruits and vegetables. Quetiapine is a second-generation antipsychotic drug that also blocks histamine H1 and serotonin type 2A receptors. Antipsychotic drugs, especially first-generation antipsychotics such as haloperidol, fluphenazine and trifluoperazine, can be associated with some serious side effects, such as the neurological disorder tardive dyskinesia.
This involves involuntary movements of the face, tongue and mouth and, less commonly, the limbs, head, neck and trunk. In some cases, tardive dyskinesia may be irreversible.
All antipsychotic drugs can also cause neuroleptic malignant syndrome, a neurological disorder which can progress rapidly over 24 to 72 hours. Neuroleptic malignant syndrome can cause instability, altered consciousness, muscle rigidity and even death. The incidence is greatest in young men. Both first- and second-generation antipsychotics have been reported to contribute to heart arrhythmia , where the electrical impluses co-ordinating your heartbeats malfunction.
In a recent large cohort study , researchers reported that antipsychotic drugs, including quetiapine, almost doubled the risk of sudden death from a heart attack. Quetiapine has fewer side effects than first-generation antipsychotics.
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