Weight gain and other metabolic side effects of bipolar and schizophrenia drugs may be countered

A new study suggests that young people who are diagnosed with bipolar disorder and schizophrenia may be spared the side-effects of taking medication with the right diet and exercise program.

Anti-psychotic drugs have been documented to cause dramatic weight gain, raised blood fats and Type-2 diabetes within the first six months of treatment. These serious metabolic diseases can lower life expectancy by up to 20 per cent and increase the risk of an early death from cardiovascular illness. Thirty per cent of men and almost 36 per cent of women, aged between 18 and 24, have experienced excess weight gain as a result of taking antipsychotics, official government statistics have shown.

Garvan Institute research to be published this week, however, shows it may be possible to take this medication without becoming dangerously obese. The new ‘treatment algorithm’ was devised by Associate Professor Katherine Samaras, Clinical Researcher at the Garvan Institute of Medical Research and endocrinologist at St. Vincent’s Hospital, along with psychiatrist Dr Jackie Curtis and her colleagues from Prince of Wales Hospital.

An early psychosis program, run at Bondi beach in Sydney's east, has enlisted clinical nurses, occupational therapists and a clinical psychologist to help 15- to-25-year-old sufferers experiencing their first episode of psychosis. It found that a supported diet and exercise program for schizophrenics taking anti-psychotic medication yielded significant health benefits within just 12 to 16 weeks.

The Early Intervention program paper said that while further research was needed, there was sufficient evidence to support early intervention and prevention strategies for younger patients. Associate Professor Katherine Samaras, a clinical researcher at the Garvan Institute, said an early intervention program could be the best way to prevent physical ill health. “With the psychiatrists and other health professionals I've been working with, we put together a simple `how to' which we believe will immeasurably improve the physical health, and therefore the lives, of people with psychosis later on,” she said in a statement.

Someone with schizophrenia is 10 times more likely to die from cardiovascular disease than suicide, according to Jackie Curtis, the clinical leader at the Bondi centre. “Think of the amount of time we spend on suicide prevention and compare it to what we spend on this,” she said. As well as providing exercise and diet advice, young patients can be given drug treatments such as the diabetes drug metformin or cholesterol-treating statins more commonly associated with much older people.

Dr Curtis believes in future psychiatrists might automatically prescribe metformin when they put patients on antipsychotics. “We know the first 12 months of treatment for a young person who was previously not exposed to the medications is the greatest period of weight gain,” she said. Dr Curtis said she hoped to do further research to identify whether it also improved the psychiatric outcomes of the participants.

The treatment program was adopted by NSW Health in June 2011 and is now also practiced in the UK.

Dr. Ananya Mandal

Written by

Dr. Ananya Mandal

Dr. Ananya Mandal is a doctor by profession, lecturer by vocation and a medical writer by passion. She specialized in Clinical Pharmacology after her bachelor's (MBBS). For her, health communication is not just writing complicated reviews for professionals but making medical knowledge understandable and available to the general public as well.

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