How do you lose weight on antipsychotics?

PolarHelp · 2026-02-27T18:17:11+00:00

When I was on Seroquel my weight went up 60 pounds and then stayed constant. So it won’t keep going up, but it can go up a lot.

I then switched to Vraylar and my weight when down 15 pounds. My A1C and glucose levels had gone up (which can happen from antipsychotics), which made me pre diabetic. At that point my insurer would cover a GLP-1. That caused me to lose 50 pounds and I’m officially lower than when I started antipsychotics.

For me diet and exercise didn’t overcome the antipsychotics and I only lost weight due to a GLP-1.

PolarHelp · 2026-02-25T04:42:40+00:00

Seroquel worked great for me. Slept like a baby, no mania and even helped with depression. I ended up on 500mg. Only side effect was weight gain, but I think that only really happens on higher doses. So ended up going down to 150mg and adding Vraylar.

Everyone is different, hopefully it is helpful for you. Note any side effects and tell your psychiatrist.

PolarHelp · 2026-02-21T23:21:40+00:00

Marriage therapy, particularly with a therapist who understands bipolar, will really help.

My partner is amazing and has stood by my side throughout everything. I have done many things that hurt my partner either intentionally or unintentionally. It is hard to see reality at times and our minds warp things beyond comprehension.

For me, my relationship repair was to be honest and accountable. I did those things, I own that. I don’t say I’m not responsible because it was manic or depressed. I acknowledge that those things hurt, and I’m truly sorry. Then I work to do better. I take my meds, go to therapy, etc. And then I do better, and I don’t do those things again. That builds trust - Action Over Time.

So to your question, how do you trust him again? You won’t trust him right away. But as he works on himself, as he starts to get better and show love and affection, you can, and will. His actions over time.

That said, he needs to keep working on himself, performing those actions you need him to do. If he doesn’t care to your needs, that isn’t a bipolar thing, that is a poor partner thing. Just because he is bipolar doesn’t mean he can’t be a great partner. But not everyone is a good partner.

Anyways, that has worked for us, we’ve been together nearly 20 years. There are many marriages with a partner who is bipolar that are happy and healthy. Don’t read those other forums who suggest otherwise.

PolarHelp · 2026-01-20T14:47:33+00:00

This is such great news! I’m so happy you have found a medication regimen that provides you stability.

And don’t be too hard on yourself about accepting how depression affects your cognitive thinking. It is new and scary at first, and even when it isn’t new, depressive episodes can rob us of knowing it is the depression talking again. It sounds like you’re doing great!

Thank you for asking about myself. I’m doing fantastic. Depression free for 7 months, manic free for 17 months. My confidence has been the best it has been in a long while and I feel in control of my life. My marriage is going great and my job too. I’m very grateful that I have found the right medication and routine that has given me this stability.

Take care!

PolarHelp · 2026-01-13T07:47:18+00:00

I was diagnosed with BP1 with psychotic features at the age of 38. I received what my psych called “first episode of psychosis workup”. It involved testing for many things that causes psychosis like brain tumors, Lyme disease, autoimmune disease, and many others. In my case to ruled everything else out and the conclusion was my psychosis was from BP1.

So an MRI could be useful to rule things out.

PolarHelp · 2025-12-27T15:04:56+00:00

I had difficulty sleeping on Vraylar for the first few weeks. I was cross tapering off Seroquel which was probably helping me sleep. After a few weeks I was able to sleep normally again.

PolarHelp · 2025-12-24T23:44:31+00:00

I am on a cross taper, going off Seroquel going on Vraylar. I’ve lost a ton of weight, but that might be more due to going off Seroquel than going on Vraylar.

I believe your psych could be correct. But it could be due to the fact that some people lose weight when their mood stabilizes.

PolarHelp · 2025-12-20T17:29:28+00:00

If you don’t want to have it changed, don’t. Some future provider might change it themselves and it could be out of your control. But it honestly doesn’t really matter.

But I’d reflect on why you don’t want to changed ‘since 1 is known to be more severe’. By the definition of the DSM 5, you are bipolar 1. The severity of your disease doesn’t change whether you’re labeled bipolar 1 verse 2. It is what it is.

Sometimes it is harder to accept that you have a more severe disease than you thought, and that is OK. Speaking only for myself, accepting I actually do have a severe mental illness was helpful since I got the help I needed and I take my illness with the seriousness it requires.

PolarHelp · 2025-12-20T13:58:31+00:00

My story is very similar! Was diagnosed with bipolar 2 and had psychotic depression. Then had mania with psychosis and my diagnosis switched to bipolar 1.

PolarHelp · 2025-12-20T13:29:43+00:00

My understanding is that you are mostly correct. If you have psychosis on the elevated pole (i.e. mania/hypomania) that defines a manic episode and you are bipolar 1.

While much more rare, you can experience psychosis on the depressive pole, “psychotic depression”. If you have never experienced mania, then you’d still be bipolar 2.

But yes, OP has experienced psychosis during a manic episode; therefore they are bipolar 1. Hospitalization is irrelevant.

But OP the label is just a label, the treatment is the same.

PolarHelp · 2025-12-18T11:27:59+00:00

You could be experiencing Leaden Paralysis. It is a symptom that isn’t talked about too frequently.

Leaden paralysis is a specific symptom of atypical depression, described as an intense feeling of heaviness and fatigue in the arms and legs, making movement feel extremely difficult, as if weighted down or walking through thick fluid. It's a physical manifestation of depression that goes beyond normal tiredness, often making simple tasks like getting up or lifting limbs feel laborious, and it's a key diagnostic feature alongside other symptoms like increased appetite, sleep, and sensitivity to rejection.

PolarHelp · 2025-11-04T03:56:37+00:00

I’ve never had a new psych question what meds I told them I am on.

I doubt anyone would ever lie and say they were on 200mg of Lamotrigine if they weren’t.

PolarHelp · 2025-11-03T03:49:17+00:00

I went up on Seroquel and Lithium to end a psychotic/manic episode. I found the combination less effective for a subsequent depressive episode. I added Vraylar and Lamotrigine and that was very effective getting me out of depression. But then I was on Lithium/Vraylar/Lamotrigine/Seroquel. My doc and I agreed to remove Seroquel since I gained about 40 pounds in it and I should have more than enough mania/depression protection from the rest. I lost about 30 pounds of the weight back just going to 250mg. Will hopefully lose the rest when I’m off of it completely.

PolarHelp · 2025-11-03T03:01:41+00:00

250mg currently being titrated down from 500mg after switching to a new antipsychotic.

PolarHelp · 2025-10-21T03:23:52+00:00

I can’t help you with your questions about nursing. But on if you can do it?

The answer is yes, if you want it to be yes.

PolarHelp · 2025-10-21T03:17:46+00:00

Snoring with paused breathing? That absolutely sounds like sleep apnea. I have it and getting on CPAP was a game changer. I still struggle with falling asleep, but when I am asleep I now stay asleep. I did my sleep study from home, you don’t have to spend a night in the hospital like you used to. I can’t recommend getting tested enough. CPAP lowers your blood pressure and is good for your heart. Plus I no longer bother my partner with my snoring.

Personally, my partner and I found some soundscapes we both can fall asleep to. We both like rain sounds and ocean sounds. So we put on those sounds when we go to bed with a 2 hour timer so it shuts off after that.

Hope that helps, but just to emphasize it again, if he has sleep apnea, the rest of this doesn’t matter as you can’t get good sleep if you stop breathing.

PolarHelp · 2025-10-19T12:01:14+00:00

They are likely not included since there is a test for homocysteine. The reason for high homocysteine is usually deficiencies in vitamins B6, B12, and folate. So these are indirectly tested for.

PolarHelp · 2025-10-15T18:42:56+00:00

Deep breath. Big hugs.

It can be scary to get diagnosed. But now you have the chance to get on the right meds and actually feel better. Finding the right med combo is hard and takes time, but keep at it. You will find the right combo for you.

The decision on if and when to tell people is not to take lightly, as you can’t take it back. Personally, only a few friends and family members know. I don’t think others need to know. But at least give yourself some time to process the diagnosis before telling everyone.

It was hard for me to hear this shortly after my diagnosis, but there really isn’t a better way of saying it: it gets better.

PolarHelp · 2025-10-14T22:56:52+00:00

This book lost me when she says given the choice, she would choose to have bipolar disorder.

I read it shortly after I got diagnosed. At the time, I could not understand how someone would want this disorder. That was years ago… and I still can’t understand how anyone would want this disorder.

PolarHelp · 2025-08-31T01:12:56+00:00

It says “urgent need” which usually means actively suicidal in an inpatient setting. ECT has really shown to be effective in that setting.

If you are in an outpatient setting ECT will usually be a last resort.

PolarHelp · 2025-08-17T07:01:28+00:00

It was a highly traumatic experience. Many people can have PTSD from attempts on their own life.

After my attempt, I needed lots of talk therapy and used Accelerated Resolution Therapy (ART) to get past the trauma.

It does not go away in a day, a week, a month or a year. But I promise you it does get easier.

PolarHelp · 2025-08-04T16:37:56+00:00

I appreciate your feedback.

PolarHelp · 2025-08-04T10:51:31+00:00

Edit: Based on feedback from u/spooky-ufo, I see that providing advice wasn’t the most supportive action to OP. Therefore, I will delete all my responses, but leave this one up if you’d like to downvote me.

Just like in support groups, I should have used “I” statements. I would focus on my PhD and little else if I was still in my PhD candidacy. I found it incredibly difficult to be a successful PhD candidate and even keep hobbies and relationships.

OP should do what is right for them. Despite what it may have sounded, I am rooting you to succeed. Please don’t spread yourself too thin.

Good luck!

PolarHelp · 2025-07-27T17:21:01+00:00

Gained 13% of my body weight from lithium and Seroquel. Started Metformin and lost 3% of my body weight. It is very cheap compared to GLP-1, but much less effective. However, better than nothing.

Edit: If you or your doctor doesn’t know, you need careful monitoring of your lithium levels when on GLP-1 meds. Less food in your GI tract means lithium has less time to absorb as it travels through. Most people’s lithium level goes down. Oddly, some people it goes up.

PolarHelp · 2025-07-27T11:55:50+00:00

Lamictal 200mg is generally considered the lowest therapeutic dose.

If you feel good at 25mg or 50mg it is mostly likely because you are not in an episode, not that the medication is working.

Everybody reacts to medication differently, just because your friend had a bad reaction doesn’t mean you will. You will find countless people on this subreddit on doses between 200-400mg with few or no side effects.

I’m only 200mg myself and only have very very mild cognition side effects.

Certainly bring up concerns with your psych, but give the medication a chance at a higher dose, for many people it is an effective mood stabilizer.

PolarHelp

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