Abilify (Aripiprazole) is an atypical antipsychotic drug that is commonly used to treat severe psychiatric conditions like schizophrenia and bipolar disorder. In recent years, it has been heavily marketed as an antidepressant augmentation strategy. Despite the fact that this has been one of the most profitable medications of recent years, some research has suggested that its efficacy appears to be average.
In fact, most people end up eventually discontinuing treatment as a result of either the drug failing to treat their symptoms or tolerability issues. Like all antipsychotics, Abilify is capable of causing severe health problems such as neuroleptic malignant syndrome, high blood sugar, and increased risk of death. Additionally, even among individuals for which the drug is working well to manage symptoms, side effects like weight gain may be highly discouraging.
Abilify and Weight Gain
There is a lot of conflicting information regarding whether Abilify actually causes weight gain. Some doctors will explain that the drug is “weight neutral” and unlikely to affect your body-weight, while others may suggest that you’ll gain a marginal amount of weight throughout treatment. While compared to other atypical antipsychotics, Abilify tends to result in less “weight gain,” it doesn’t mean that the drug should be considered weight neutral for everyone.
The truth is that most people end up gaining some weight throughout their treatment with this drug. It is believed that its antagonist effect upon the 5-HT2C receptor is what may cause the gain.
How Abilify Causes Weight Gain
There are many ways in which this drug is capable of causing you to gain weight. Understand that what causes you to gain weight from this drug may be different for someone else. One person may experience an increase in appetite and start eating more, while another may believe their metabolism slowed. In other cases, a combination of these factors could lead to weight gain.
- Appetite increase: Some people that take Abilify notice that it makes them have a bigger appetite than they did prior to taking it. If you constantly feel hungry and find yourself eating whatever food is in sight, it’s probably related to the medication. For some individuals the increase in appetite is modest, while among others it’s significant.
- Blood sugar spikes: This is a drug that has been noted to affect levels of blood-glucose or blood sugars. When blood sugar levels are not stabilized, their instability may foster weight gain in some people. It is best to keep blood sugars in check throughout treatment and know that Abilify may be contributing to glucose spikes.
- Cravings for food: If you find yourself craving food throughout the day, it could be from this medication. Many people taking antipsychotics have noticed that they start to crave unhealthy foods such as refined carbohydrates and sugars (e.g. candy) during treatment. Craving food as a result of Abilify is a factor that may lead to weight gain.
- Fat storage: It is believed that antipsychotics have potential to modify the body’s fat storage mechanisms. This leads to more fat being stored in unwanted areas of the body and thus more overall weight gain. If your fat mass has significantly increased throughout treatment and your weight has gone up, it’s likely a result of Abilify.
- Going out to eat: Assuming this drug helps with your psychiatric condition, you may start to feel more comfortable in public and/or may even start hanging out with friends again. Being social and more comfortable with yourself could lead you to go out to eat more frequently. Dining out tends to involve eating unhealthy foods with large portions. Additionally, if you start going to get “fast food,” it should be relatively obvious why you’re gaining weight.
- Hormone levels: Abilify is capable of altering levels of naturally occurring hormones throughout the body. Disrupting homeostatic hormone levels with an antipsychotic drug may account for weight gain in some cases. Any drug that significantly affects the hormones naturally produced by your body could result in substantial weight gain.
- Motivation deficit: Although the drug may affect everyone differently in terms of motivation, some people notice that their level of motivation significantly wanes throughout treatment. If you become less motivated to stay in shape or eat healthy, this makes it relatively easy to gain weight. Some people end up becoming lazy largely due to the fact that the drug has an uncontrollable influence over their physiology.
- Side effects: You may experience unwanted side effects from the drug such as fatigue, drowsiness, and sleepiness that make it difficult to get adequate physical exercise. These side effects may be so severe, that it becomes a challenge to get out of bed in the morning. If you are debilitated by fatigue, this may further slow your metabolism because you aren’t getting much physical activity to keep it high.
- Slow metabolism: If you are eating the same foods / portion sizes and getting the same amount of exercise during treatment as you were before taking Abilify, but are still gaining weight, it’s likely due to metabolic slowing. Drugs like Abilify have a tendency to slow your metabolism, resulting in weight gain even when your dietary and exercise habits haven’t changed. This can be frustrating, but is generally accepted as part of treatment.
- Taste improvement: People who were really depressed before taking Abilify may notice that food tastes way better during treatment. Food may start to taste so good, that you may feel as though you can’t get enough. The taste improvement is likely to lead to you consuming bigger portions, more calories, and inevitable weight gain.
Note: The severity to which these factors are experienced is subject to individual variation.
Factors that influence weight gain on Abilify
There are many other factors that may influence the amount of weight you gain on Abilify. It is important to consider the dosage you’re taking, personal lifestyle factors, the duration for which you’ve been medicated, as well as if you are taking other medications.
Most people taking Abilify for schizophrenia or bipolar disorder end up taking between 10 mg and 15 mg daily, but dosage can be increased all the way up to 30 mg. In general, you are more likely to experience weight gain as you increase the dosage. This is due to the fact that at higher doses, the drug has more influence over your natural physiology.
Certain physiological functions such as the body’s ability to store fat, along with important hormone levels that help prevent weight gain, become drastically altered. At lower doses, a person is less likely to gain weight simply because the drug has less influence over your physiology. For this reason, it is always recommended to use a “minimal effective dose” strategy if you are concerned about weight gain.
2. Individual factors
In some cases, it is necessary to take personal responsibility for some of the weight that you gain throughout treatment. If you have been overworking, not getting enough sleep, are eating a poor diet, or aren’t getting much exercise, those are all factors that can contribute to weight gain. It is often important to consider that there are certain behaviors that you are exhibiting that are directly contributing to weight gain.
There are also other individual factors such as: age, baseline metabolism, and genetics that could influence whether you gain weight while taking this drug. In order to get a better understanding of how your genetics may be reacting to the drug (to cause weight gain), you could look into a test called “GeneSight.” This type of test analyzes some genetic biomarkers and predicts whether you will react favorably vs. unfavorably to a particular psychiatric medication.
3. Time span
The duration over which you have taken the drug may have an impact on the amount of weight you gain. Some people notice significant weight gain in the short-term (i.e. 6 weeks), while others notice more significant weight gain over the long-term (i.e. years). In any regard, it is thought that the longer duration over which you have been treated with this drug, the more likely you will have gained weight.
Short-term: The shorter the term over which you’ve been taking the drug, the less likely you will be to have gained weight. It should be noted that some people experience a major spike in weight during the early stages of treatment, with no further significant weight gain over the long-term. Others experience an initial spike in weight, followed by more gradual increases in weight over the long-term. There are cases of patients gaining 20 lbs. within just 60 days of treatment.
Long-term: Those that have been taking Abilify for a long period of time are more likely to have experienced some sort of weight gain compared to those who only took it for a short duration. Being treated over the long-term generally results in a greater severity of drug-induced physiological alterations. Therefore homeostatic functions and hormone levels will be further from the baseline. It should also be noted that as a person stays medicated over the long-term, they may develop a tolerance. This generally results in a dosage increase, which is known to promote further weight gain.
- Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3000187/
4. Other medications
There are studies suggesting that certain medications are capable of causing increased weight gain while on Abilify. If you are taking a serotonergic antidepressant (SSRI) along with Abilify, there is greater likelihood that you’ll gain more weight than someone taking only Abilify. If you are on multiple medications, it is important to review them with your doctor to determine which may be the primary culprit for your weight gain.
Also understand that if you are taking a stimulatory drug such as Adderall or a non-serotonergic antidepressant, you may remain weight neutral while taking Abilify. Those that remain weight neutral are generally on a medication to stimulate the central nervous system, which helps offset the metabolic slowing that stems from antipsychotic usage.
How much weight will you gain from Abilify?
There’s no predicting exactly how much weight you’re going to gain from taking Abilify. Since there is significant individual variation, you’ll need to first take the medication for awhile and then evaluate whether you’ve gained any weight. Some people have reported that they gained an average of 5 lbs. to 10 lbs. per year of treatment, while other people have gained 40 lbs. within the first 6-months of treatment.
In other cases, people end up not gaining any weight. Although the average weight gain for adults taking Abilify is unknown, the experienced doctors know that on average, patients are probably going to gain at least 10% of their pre-drug body-weight as a result of the medication. Assuming you are 200 lbs. starting treatment, you may end up gaining at least 20 lbs.
Will everyone gain weight while taking Abilify?
Despite the fact that an overwhelming majority of people who take Abilify will gain weight, it doesn’t meant that everyone will experience noticeable weight gain. Some individuals may remain weight neutral (and in rare cases lose weight). Those that remain weight neutral generally are able to maintain a healthy diet, physical exercise, and/or are taking a medication that helps offset the weight-gaining effects of Abilify.
It is also important to point out that for people in need of an antipsychotic, this is considered one of the most “weight neutral” options. Nearly all antipsychotics are likely to cause some sort of weight gain, but Abilify is suggested to cause less weight gain than most others. Some people may experience weight loss if they switched to Abilify from another antipsychotic (e.g. Zyprexa) that is known to cause greater weight gain.
“Weighing” the Pros and Cons of Abilify
Throughout your treatment, it is important for you to conduct a cost-benefit analysis of this drug. In other words, “weigh” the side effects (including weight gain) and determine their severity. Next take a look at how well the drug is working to treat or manage your condition. If Abilify is working great to treat your condition, but you experience some minor side effects, it’s probably a good idea to continue treatment.
On the other hand, if you have gained a bunch of weight and the drug just isn’t working very well, you should talk to your doctor. Generally if a drug isn’t working to treat your condition and/or side effects are interfering with your well-being, you may want to consider a medication switch or Abilify withdrawal. No medication is worth staying on if you aren’t getting benefit.
Did you gain weight while taking Abilify?
For those that took Abilify, be sure to share whether you experienced weight gain. Was it consistent with the idea that you’ll gain at least 10% body-weight throughout treatment? If you gained weight, be sure to mention how much weight you gained, whether you noticed you gained more weight when your dosage increased, and how long you’ve been taking Abilify. Also be sure to note any other possible factors that may have caused you to gain weight throughout your treatment.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/23469329