13 Yr.Old's 8 lb Weight Gain & Meds
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Q:  13 Yr.Old's 8 lb Weight Gain & Meds

Is it advisable for an M.D.(at my local family clinic) to change my 13 year old daughter's med. from zyprexa(5mg) to lithium.  She has gained 8 lbs. and he thinks this is a social issue for her.  A psychologist changed her from depakote to zyprexa during a hospital stay almost 2 months ago.  I think she has done significantly better on the zyprexa and don't want her to change to lithium when the zyprexa is agreeing with her.  "If it ain't broke- don"t fix it!!" please advise. thank you for having this site

Dear Ms. C' -- 
The good news is that you've found one agent that works so well for your daughter (Zyprexa).  That's great.  Now, is there anything "broke"?  Is 8 pounds worth worrying about?  

You bet it is.  Eight pounds could be only the beginning of 30 pounds, and a risk of getting diabetes from it.  This is a well-recognized problem we see with Zyprexa.  So I agree with her doctor on the wisdom of looking for -- hopefully -- another way of keeping symptoms controlled.  

There is a sliver of evidence for yet another way to solve this problem, which I've summarized under the title "Metabolic Syndrome".  If you read the whole thing you'll see there might be a way to salvage Zyprexa with metformin.  Zyprexa is so good, perhaps better than anything else at controlling symptoms, but the weight gain must be attended to.  The manufacturer likes to promote wise diet and regular exercise, but I think that's just inadequate as protection against the weight gain -- though sensible in any case.  

Alternatively, on the list of mood stabilizers, there is Trileptal; though we have less experience with it and so far it looks like it works, but perhaps not with the clout of Depakote, and Zyprexa is looking even stronger than Depakote these days based on two new studies. 

Dr. Phelps

Published March, 2003


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