Expert: Joyce A. Anthony - 9/16/2010

Question
Hey Joyce,

With teenagers in mind, are you aware of any anti-psychotic medications that don't cause weight gain?

I'm the bipolar father of a probable bipolar 17 year old daughter.  Our family physician has been trying treat her with low dosage prozac, Buspirone (for anxiety during mania) and trazedone to help her sleep.

I say "probable bipolar" because she hasn't been diagnosed by a psychiatrist.  Our doctor says he has reached the limits of his competency and wants her to see a psychiatrist because the anti-depressants are triggering mania, which is common for bipolars.  Given the family history and her similarity to me, along with her behavior and moods, its pretty much a given that she's the real deal.

I take Symbyax and it works wonderfully, but I've gained 40 pounds thanks to the Zyprexa component.

I realize the psychiatrists will have her own suggestions when we eventually see her.  However, I'd like to do some research and thinking of my own about the available drugs before I say yes to whatever it is she suggests.  And I'm mainly interested in anti-psychotics.

Answer
Hi Sam:

Having a teenager myself, I can understand the concern about weight gain.  Seroquel is a wonderful choice.  While there have been some who have gained weight on this, a normally active person, as a girl your daughter's age most likely is, will have no problem. Many teens have found they have actually lost weight because the medication regulates the moods and the tendency to eat when depressed is eliminated.  In addition, Seroquel may make it possible to eliminate the Trazadone as it promotes sleep.

If the psychiatrist does diagnose bipolar disorder, ask about Lamictal, or a combination of the Lamictal and Seroquel.  Lamictal definitely does not cause weight gain, which is also a side effect of most mood stabilizers.  These two are the best choices of those available today.
                      Joyce A. Anthony