What Causes Weight Gain From Mood Medications?

[historyteach]

I found this interesting article on psycheducation.com and thought many would be interested in reading it. Weight gain, and its complications are a common problem for many of us. Here is some hope!

Hopkins Scientists Uncover Cause Of Antipsychotic Drug Weight Gain
ScienceDaily (Feb. 16, 2007) —

Johns Hopkins brain scientists have hit on how and why some powerful drugs used for treating mental illnesses cause patients to gain so much weight that they often develop life-threatening complications such as diabetes and heart disease.


"We've now connected a whole class of antipsychotics to natural brain chemicals that trigger appetite," says Solomon H. Snyder, M.D., professor of neuroscience at the Johns Hopkins School of Medicine. "Our identification of the molecular players that link such drugs to increased food intake means there's now hope for finding a newer generation of drugs without the weight-gain side effects."

The discovery will be published online next week at the Proceedings of the National Academy of Sciences.

Previous research already had fingered increased levels and actions of one particular enzyme, AMPK, in brain cells as a control lever for appetite in mice and presumably humans.

Suspecting that antipsychotic drugs might spike AMPK in the brain to overact, the Johns Hopkins team injected mice with clozapine (Clozaril), which, with olanzapine (Zyprexa) and risperidone (Risperdal), is commonly prescribed for schizophrenia and bipolar disorder in people who do poorly on conventional drugs.

Mice given clozapine showed quadrupled AMPK activity compared to activity measured pre-drug.

The researchers then gave the mice leptin, a hormone that suppresses appetite, and as suspected, saw lowered AMPK levels.

Drilling down further into what controls AMPK and its boost of hunger, Sangwon Kim, Ph.D., a research associate and lead author of the study, "rounded up the usual suspects, brain proteins known to relay communication from cell to cell."

Systematically manipulating these cell-signaling proteins, Snyder's team found that blocking one in particular, a receptor site for histamine, a well-known player in triggering classic allergy symptoms, activates AMPK to the same extent as clozapine. To confirm that the histamine receptor connects the drug, AMPK activity and appetite, the team gave clozapine to mice genetically engineered without a histamine receptor.

Results? Peace. No heightened AMPK activity.

"Histamine also has a long history as a suspect in weight control, but no one ever could put a finger on the exact link," says Snyder. "The connection we've made between its receptor and appetite control is incredibly intriguing and opens new avenues for research on weight control, possibly including drugs that suppress appetite safely."

The research was funded by the U.S. Public Health Service, Canadian Institute of Health Research, National Institutes of Health and National Multiple Sclerosis Society.

Authors on the paper are Kim, Alex Huang, Adele Snowman and Snyder of Hopkins, and Cory Teuscher of the University of Vermont College of Medicine.
Adapted from materials provided by Johns Hopkins Medical Institutions.

Shalom!

[mle-sober]

Okay, I'm sorry. I feel stupid. Could you sum that up for me? My brain just doesn't work the way it used to.

I've been told the drugs I'm on don't in and of themselves cause weight gain. My doc said, "You still control what you put in your mouth." She really said that. It was so helpful. After I'd gained 30 pounds.

Is this article a confirmation of this or an addition to this in any way?

[historyteach]

In a nutshell, these drugs DO trigger your appitite at the molecular level. As such, they are now difinitively known to increase food intake. So, while it is true that we all control what we put into our mouths, this article shows that, those taking certain drugs have artificially increased hunger *because* of those very drugs!

So, shame on that doc for saying that to you!!!

Print this out and send it to him/her.
Better yet, bring it to him/her and ask for an apology! Cuz most docs, even GP's, are aware of the problems inherent in the drugs for certain medical conditions that cause increase weight. They certainly should NOT be blaming the victim!

Even as I say that, I recogize that we are still responsible for doing everything possible to maintain our good health. Exercise and eating properly are still within our control, and will minimize the effects of those medications.

Shalom!

[deerwalk]

If it were me I would rather report the doctor or "grade" them on one of the online sites where one can do so. Sounds like the doctor was making a point in an extremely insensitive way to someone who was already in a vulnerable condition. Doctors... They are in control of how they behave around patients and I have found that many exercise no control, even yelling at a patient. Bedside manner has gone out the window, sorry Mle- you deserve better.

[historyteach]

I know what you are saying, Deer.
But, Mile, was this a one time incident? Is your doc normally a great person who just blew it this time?

I ask because I've known and loved my doc for @ 15 years. I would never consider leaving him. But, he had a bad day one time, and was short with me. It hurt my feelings at the time, but, looking back, I see that he was only human. Doctors are falible *because* they are human. And I would have been foolish to have judged him harshly for that one time out of literally hundreds of times over the many years.

On the other hand, if the doc is always insensative, find a new one, yes. No one deserves to be disrespected.

But, an honest assessment is necessary before we make a public judgement on a professional. It's only fair. It's what we would want for ourselves, no?

Shalom!

[deerwalk]

Mmmm.. guess so. But I was a mere receptionist at an art gallery for unappreciative, self entitled rich people and was fired without notice and without reason... If a lackey like me can get maximum punishment for nothing, doctors should even more so be under scrutiny, especially considering that a doctor's attitude can affect a patient's health negatively. I only speak from experience. I was treated as a "lesser than" every day and smiled through it all until one day- done.

[mle-sober]

For the most part I like my doc. She's actually a nurse practioner with prescriptive privledges. It takes so long to tell my whole story and get someone up to date I hope I never have to switch docs, truthfully. It's takes 2 hours. It's exhausting.

I have lost all 30 pounds that I initially gained. But it has felt like a huge struggle. And I constantly have to work to not eat more than I really need.

Mainly, it's nice to feel supported (by your article that you shared) and a little vindicated, you know? I can let it go with my doc. The thing that I am always aware of is that the medical people, although they are trying to help you, don't really understand what it's like to be mentally ill. They can't know. No matter how much they study.

But, serious increase in appetite is a price I'm willing to pay in order to be sane and capable of taking care of my children.

Thanks for the article. I appreciate it.

[historyteach]

I'm sorry, Deer...
That treatment *never* should have happened to you!
It's horrible that anyone should treat another human being in such a manner!

I do think that doctors are held under a higher standard of behavior.
That doesn't mean they aren't human, though, and because they are human,
they are capable of doing some of the same stupid things we all can do -- myself included.

I do hope mle's doc does apologise.
When I recognize I mess up with my students,
I have no problem making a public apology to them.
It lets them know that I'm human and I make mistakes, and
It serves as a good role model for them to do the same when they make a mistake.
In that sense, we all come out winners, yes?

Deer,
For what was done to you; for how you were treated,
I am truely sorry...
You didn't deserve it.

Shalom!

[historyteach]

You're very welcome, Mle!
Good luck with the weight and I"m glad that the article helped.

Shalom!