Anti-psychotics make you fat.   Here is a relatively safe do-it-yourself option, that may help to minimize the weight gain and metabolic disturbances.

Click to listen to the audio…

Strategies to lower weight gain when taking  anti-psychotics

Anti-psychotics make you fat. Here is a relatively safe do-it-yourself option, that may help to minimize the weight gain and metabolic disturbances

When you’re metabolically challenged, there is a tendency to blame YOU 

• You’re not eating right.
• You’re sitting on the couch.
• You’re………….. WHATEVER !

But, the reality is, it’s seldom that simple.

Yes, sometimes your habits and behaviours nudge you in the wrong direction.

There is a lot of NOISE when it comes on this topic, so we could debate, which habits are problematic.   The interesting thing…………sometimes the problem is being caused by the medical fraternity, DIRECTLY.

Prescription meds.

Blaming the meds for weight issues

There are quite a few that have been directly implicated in weight gain and metabolic mayhem, among them

Proton pump inhibitors, anti-histamines, ……..anti-psychotics.

Today, I want to talk about anti-psychotics, which are meds that are used to treat serious mental illness, conditions like

• Schizophrenia
• Bipolar disorder
• Depression
• Personality disorders

Anti-psychotics and weight gain

All anti-psychotics cause a problem, but some are worse than others.   The group which is particularly problematic, are the newer ones, officially referred to as “second generation” anti-psychcotics.  Basically, they’re the new kids on the block….

From a head perspective, they work better.

But,  the metabolic fall out more pronounced, stats suggest up to 60 % of patients are impacted.

Is there a fix for anti-psychotic weight gain ?

Now at this stage, the problem is acknowledged, however, why it happens is still contentious  and  the options to deal with it, are limited.

Option 1 – don’t take the med

For many don’t take the med is not a workable solution  – they just can’t move through the world without pharmaceutical help.

Option 2 –  Choose an alternative med

Chemically speaking, there are quite a few drugs which have anti-psychotic effects.  As a rule, they all work by altering dopamine levels in one way or another.  This is how they provide their anti-psychotic benefits, but  it is the altering the dopamine levels, that creates the ‘weight problems”, so the take an alternative, also isn’t all that helpful.

It is a class effect.

That said, experimenting with options might find a pill that works better for you.

Option 3 – Hedge your bets

Resign yourself to the fact that IT IS GOING TO HAPPEN and get pharmacological help, up front.  The prophylactic of choice is typically metformin, a widely prescribed anti-diabetes medication.

A new option ?

Adjusting the timing of the anti-psychotic dose.

This approach is something a researches based in San Diego, have been exploring,  their research suggests this is remarkably helpful tactic.  And the great thing about it, is it is a DIY option.

The drug they have  investigated is resperidone.

A commonly prescribed anti-psychotic…..

Mice DO  resperidone

They started off studying the impact of drug dose timing, in mice.  The med was hidden in a peanut butter pellet, and since, no mouse  in it’s “right” mind can resistant  peanut butter, the mice  self administered their daily dose of anti-psychotic.

NOTE :  I know a human who also can’t resistant peanut butter either. Haha !

The dose (3 mg/kg) was designed to give blood levels of drug, similar to what is seen in humans.

The researchers deliberately used female mice in this study, because female mice, are especially prone to putting on weight,  when taking anti-psychotic meds.  But, the mice  weren’t on a diet designed to make them fat –  it was ordinary chow, with a once a day  peanut butter treat.  Mouse days were 12 hours long, with the lights going on at 6 am and off at 6 pm each day.

Dosing up on resperidone

The resperidone laced peanut butter treat was  offered either as the ladies, were preparing for “their day” (5.30 pm) or just before they retired for “their night” (8.00 am).

Remember  mice are nocturnal.

That means “their day”, is actually our night and “their night”, is actually our  day.

Two weeks later

Weight gain after resperidone treatment. © 2022 Rizaldy C Zapata et al.

The ladies taking the resperidone “BEFORE BED” were significantly fatter. Putting on 2 plus grams in a week for a mouse,  is like putting on  2 kg in a week for a  human. A devastating nightmare !

One of the reasons, for this weight gain,  was they simply ate more.  This is shown in the graph below.

Food intake after resperidone treatment. © 2022 Rizaldy C Zapata et al.

When the team measured glucose levels 2 hours after the peanut butter snack, it was clear, the drug was causing TROUBLE when it was taken “JUST BEFORE BED”, but had no impact, when taken at the start of the mouse “day”.

Fasting glucose (2 h post-treatment) of mice treated with (3 mg/kg) during the light (ZT2) or dark cycle (ZT11). © 2022 Rizaldy C Zapata et al.

Timing mattered, for the mice.

Humans are NOT mice

But since  mice timing is very different from human timing, the team decided to set about exploring whether the timing mattered in humans too.

Now, strictly speaking, testing this requires a clinical trail, sommething which would have been prohibitively expensive and time consuming, so our team opted to “borrow” data from the VA San Diego Healthcare System.  They mined the data looking for patterns in  weight gain, and long-term metabolic outcomes in patients with serious mental illness, who had been prescribed resperidone for at least a year.  And they picked up the script. Suggesting they were taking the meds and were  doing it, the way they had been told to.

Patients were considered to have taken the resperidone in the morning if the instructions indicated “morning”, “daily”, “qam” or  “qday” and were considered to have taken RIS at night when the instructions indicated “qhs” or “bedtime”.

NOTE : This might not always be the case, making this data potentially a little unreliable.  In an attempt to clean up the data, veterans with metabolic problems or neurodegenerative conditions were deliberately excluded.

Even with the less than perfect data, a clear pattern emerged……

Timing matters in humans

Changes in body weight and HbA1C in veterans taking resperidone for more than 1 year. © 2022 Rizaldy C Zapata et al.

The graph above shows, those taking the drug at the start of their day, were in a much better place both in terms of weight gain and glycaemic control, than those taking the drug, just before bed.

Anti-psychotics should be taken at bedtime

If you analyse the numbers,  the vast majority were taking it just before bed, because one of the side effects of these meds……….. is they make you sleepy, so the size of the groups is somewhat imbalanced.

Despite all the “INHERENT UNCERTAINTIES” within the data, the results are unmistakable.

It probably is enough to say with some level of confidence, what happens in female mice, also happens in VA patients,  who for the record, are predominantly  middle aged men.

Option 4 – take the pill with breakfast

It works,  but thanks to the sedative effects, the  fix for the problem is not practical.  Sleep walking through your day is not conducive to functioning well. Eish !

A work around this option ?

So our team put their thinking caps on, to find a way to use this biology to bring these patients relief.  Based on their mouse data, it is clear that the problem has a circadian origin.

The resting period is NOT a good time to eat and take an anti-psychotic.

This sparked the thought…….

“What would happen if the anti-psychotic taking was divorced from eating ?

The team set about testing this.  They whipped the food out of their ladies cages, just before their bedtime,  putting  them on a time restricted feeding regimen and watched what happened.

Don’t take that pill with food

When the  peanut butter laced pill was given at bed time,  but the ladies spent the night, without access to any food, the metabolic difficulties were DIMINISHED.

Time restricted feeding mitigating the metabolic side effects of resperidone.© 2022 Rizaldy C Zapata et al.

Food intake was lower, weight gain was lower and sugar levels remained within the normal range.

A workable solution  ?

Possibly. The team will need to do a clinical trial and test the idea in humans, before it makes it into the guidelines and your doctor will advise you, to do this, when prescribing these kinds of meds.

This will take lots of money and time.

If you need to take an anti-psychotic to FEEL HUMAN

You could wait until the science comes in.

Or…………… you can give it a try.

Take your pill, the way you normally do, just before bed, but close the kitchen, early.

It’s low risk BIG REWARD strategy

Time restricted feeding  is considered SAFE – actually many would argue, it is more than safe, it is the way we’re meant to do it.

Our ancestors didn’t have access to 24/7 diners.

NOTE :  In this mice study, the feeding window was set for 12 hours.  Studies with humans, not taking anti-psychotic meds,  suggest fasting for at least 13 hours is the sweet spot, to enjoy metabolic benefits.  Click here to learn more.

Further reading

Want to discover more ways to create BETTER BODY CHEMISTRY ?