Bipolar medications and weight gain

Answer Section

Medicines are an option for treating bipolar disorder. Some of these medicines can make you feel hungrier or change how your body uses food for energy. This can lead to weight gain.

Not everyone will gain weight from these medicines. People react differently. A medicine that works well for one person might not work the same for someone else. Some medicines may be more likely to cause weight gain. Talk with your healthcare professional about these differences. You and your healthcare professional may need to try different medicines to find the right one for you.

The main types of medicines used to treat bipolar disorder include:

• Mood stabilizers. These include lithium (Lithobid), divalproex (Depakote), carbamazepine (Equetro, Tegretol, others) and lamotrigine (Lamictal). Divalproex is most likely to cause weight gain compared with others, but not for everyone. Lamotrigine is least likely to cause weight gain.
• Antipsychotics. These include olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), ziprasidone (Geodon), lurasidone (Latuda), cariprazine (Vraylar), lumateperone (Caplyta) and asenapine (Saphris). Aripiprazole, ziprasidone, lurasidone, cariprazine and lumateperone are less likely to cause weight gain than the others, but that can vary from person to person.
• Antidepressants. These are sometimes used with a mood stabilizer or antipsychotic. Using antidepressants alone can sometimes cause people with bipolar disorder to have emotional highs or switch between emotional highs and lows. Some antidepressants, such as mirtazapine (Remeron) or paroxetine (Paxil), are more likely to cause weight gain than others, but this can vary from person to person.
• Combination medicines. A generic medicine that includes both the antidepressant fluoxetine and the antipsychotic olanzapine can cause weight gain. Another combination medicine that is used to treat bipolar disorder is olanzapine-samidorphan (Lybalvi). This medicine may result in less weight gain than taking olanzapine alone.

Some medicines are less likely to cause weight gain when taken alone. But to manage symptoms, many people with bipolar disorder need more than one medicine, which can lead to weight gain.

If you gain weight, talk with your healthcare professional. The weight gain may or may not be related to your bipolar medicine. To help with weight gain, eat healthy foods, get regular physical activity and talk with a mental health professional if needed.

Keep working with your healthcare professional to manage your bipolar symptoms and your weight.