Risperdal (Risperidone) is an atypical antipsychotic medication that has been approved since 1994 for the treatment of schizophrenia, bipolar disorder, as well as certain cases of autism. It functions as an antagonist of the neurotransmitter dopamine. By acting as an antagonist, it reduces overall dopamine activity in the brain and helps eliminate many of the positive symptoms of schizophrenia such as hallucinations and delusions.
It also tends to reduce serotonin, norepinephrine, and histamine activity in the brain. Despite the fact that the drug works well to treat severe psychiatric conditions, most people that take it end up feeling sedated. In addition to feeling sedated, it is typical to experience a variety of side effects while taking this medication, including weight gain.
Risperdal and Weight Gain
There is clear evidence in support of the idea that this drug has potential to cause weight gain. It is believed that carriers of the leptin gene -2548G/A and variants may have different responses to Risperdal, and thus may not gain as much weight. That said, even possessing favorable variants of that particular gene are unlikely to inhibit all weight gain. The reality is that the majority of people are going to gain some weight on Risperdal, and in some cases the amount will be significant.
How Risperdal Causes Weight Gain
Below is a list of ways in which taking Risperdal may cause you to gain weight. Understand that everyone has a different reaction to the drug. Many people notice that their appetite increases and in some cases, they crave foods, but what they may not know is that their hormone levels, metabolism, and fat storage mechanisms may also be playing a pivotal role in weight gain.
- Appetite increase: If you’ve been taking this drug and notice that your appetite is at an all-time-high, it is important to understand that this is a common side effect. You may feel as if you are starved and need to constantly keep eating to offset the feeling of hunger. Most people have a difficult time keeping their increased appetite under control and begin devouring food like a starving man at a buffet. Up to 44% of users report increased appetite on this medication.
- Fatigue: Due to the fact that this drug acts as an antagonist for all major stimulatory neurotransmitters (especially dopamine), it tends to cause fatigue and other synonymous effects such as drowsiness, tiredness, sleepiness, and lethargy. If you feel more tired than usual, you’re going to have a tough time getting out of bed to exercise or engaging in as much physical activity as you were pre-Risperdal. This means less calories will be burned and your metabolism will slow.
- Food cravings: While taking Risperdal, you may start to crave certain foods, especially unhealthy ones like candies and refined carbohydrates. These cravings can become difficult to resist and when coupled with your newly voracious appetite, you may find yourself impulse buying large quantities of “junk food.”
- Fat storage: The way in which your body stores fat may become altered based on drug-induced hormone and glucose level fluctuations. As you take the drug, it interferes with natural homeostatic processes that work to break down fat and use it as energy. Instead, this drug slows the process and/or may initiate fat-storage processes throughout the body.
- Hormone levels: Research shows that Risperdal alters levels of various neurohormones, including “leptin” which plays a role in appetite regulation. When leptin levels decrease, weight gain tends to occur because appetite is stimulated. Other hormones like testosterone typically become lowered as well, leading to weight gain in unwanted anatomical areas (e.g. breasts in men).
- Mechanism of action: It is believed that this drug’s effect on the 5-HT2C receptor and H1 receptor are both capable of causing weight gain. The former tends to influence the amount of leptin (appetite regulating hormone) and the latter influences arousal. While these aren’t the only mechanisms that account for weight gain, they are considered influential.
- Mood improves: An improvement in mood may not directly contribute to weight gain, but in some cases it does. Some people end up not eating adequate portions due to the fact that they are depressed from their illness. When they get symptoms under control, their mood brightens and this leads to a normalized eating schedule as well as portions; resulting in weight gain.
- Motivation decline: Although the drug may be helping you manage various symptoms of your illness, some individuals may experience a decline in motivation during treatment. This may be related to the antagonistic effects of the medication on dopamine as well as histamine. If you feel less motivation while taking this drug, it will be tough to keep weight off.
- Slow metabolism: It’s no secret that atypical antipsychotics can slow the metabolism, and Risperdal is no exception. This means that even if you are able to maintain the same level of physical activity, are eating the same portion sizes, and same foods as you were pre-treatment, you’re going to gain weight. This can be highly frustrating because no matter how strict you are with your personal care, you’ll probably still gain some poundage.
- Social eating: Now that you’ve got symptoms under control from the medication and are feeling better, you may start to socialize more often. This could be with friends or colleagues at work, and before you know it, you end up making dinner plans. Pretty soon these dinner plans become weekly or in some cases, daily. Eating out with friends is a quick way to gain weight, mostly due to the abundant portions.
- Taste improvement: For some people, food may start to taste better when taking Risperdal. Although it is restricting dopamine activity, many people are still able to experience pleasure when eating during treatment with this medication. If taste starts to improve, you’ll probably end up consuming more food.
Note: For most people, a combination of the factors listed above play a role in weight gain. Since everyone is different, it is important to realize that the degree to which each factor listed plays a role should be considered on an individual basis.
Factors that influence weight gain on Risperdal
There are several additional factors that influence the amount of weight you’ll gain while taking Risperdal. These are factors that can be highly influential in regards to the amount of weight gain you experience and tend to vary based on the individual.
The amount of this drug that you take can play a role in determining how much weight you gain. At higher doses, you are more likely to experience weight gain simply due to the fact that the effects of the drug are amplified. At higher doses, the drug has more control and influence over your hormones, neurochemistry, and other physiological processes.
If you are serious about minimizing potential weight gain on this drug (as well as other unwanted side effects), you should always strive to take the “minimal effective dose.” By taking the minimal effective amount, you will still be treating your mental illness, but won’t be giving the drug as much influence over homeostatic processes. The lower the dose you can get away with, the better in terms of weight.
2. Genetic variants
Your genetics play a significant role in determining how much weight you’ll gain from this drug and many others. Although most people will gain weight on Risperdal regardless of their genetics, people with certain genes experience significantly less weight gain. Variants of the leptin gene “-2548G/A” generally have a weight-altering effect.
If you have the right variant of this gene, you may not gain as much weight. Research indicates that people with the GG-genotype carriers experience 2.5x less weight gain than those carrying the A-allele. Fortunately new technology like “GeneSight” may be able to help predict how you’ll react to this drug before you take it.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/19873684
3. Duration of treatment
How long have you been taking this drug? Those that take Risperdal for extended periods tend to experience more weight gain than those on it for a short-term. Although short-term fluctuations are common, and some people do still pack on a lot of weight in the first 6-weeks of treatment, weight gain tends to be more significant over the long-term.
The longer you take a particular medication, the greater the extent to which your physiology will have adapted to its effects. Longer term users are more likely to develop tolerance, which often leads to an increase in dosing (a factor that commonly also increases weight). The longer the term you’re on this drug, the more weight you’re likely to have gained.
4. Other medications
If you are taking other medications, it is important to realize that they may be contributing to weight gain independent of Risperdal. In other cases, the other drugs that you take may be working synergistically with Risperdal to increase your body-weight.
Another scenario could be that the medications you are taking may be helping offset some of the weight gain associated with Risperdal. To get a better understanding of how various medications that you’re taking may be influencing your weight, be sure to talk to your doctor.
5. Lifestyle / habits
It is important to analyze your own life and determine whether your lifestyle and daily habits could be contributing to weight gain. If you make no effort to eat healthy foods, stay conscientious of your dietary intake, and don’t get much physical activity – you may be (partially) to blame for a weight increase. Other factors like your stress level and amount of sleep that you get can have an influence over your weight.
How much weight will you gain from Risperdal?
There’s no exact number that can be stated in response to how much weight you’ll gain. This is because weight gain is largely individualized and based on many factors. For most adults, an increase of 5% body-weight tends to occur as a result of treatment. In other words, if you are 200 lbs. entering treatment, you may gain 10 lbs. while taking Risperdal.
In small-scale studies with children and adolescents, weight gain was roughly 10 lbs. after taking the medication for 6 months and was accompanied by a BMI increase of 1 point. Unfortunately most studies documenting weight gain from Risperdal are relatively indirect. However, it is widely accepted that this drug will cause an increase in weight.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/23519708
Will everyone gain weight while taking Risperdal?
It is estimated that up to 10% of users report weight gain while taking this drug. The reality is that not everyone “reports” this side effect and thus saying that 1/10 users is likely to gain weight may be a skewed statistic. Based on the profile of the drug and the fact that 44% of people “report” increased appetite, it should be assumed that a significant number of users will gain weight.
In fact, some people may consider it to be an oddity if you don’t experience some weight gain from the drug. Whether you consider the amount of weight gained as being “significant” is another story. The reality is that many people taking Risperdal are likely to gain some weight and their BMIs are likely to increase as a result of treatment.
Does Risperdal’s therapeutic effect outweigh the weight gain?
If you are taking this drug, it is important to evaluate the therapeutic effect of the drug in comparison to the side effects that you are experiencing. If you experience an array of unwanted side effects, but the drug is working extremely well, it may be worth continuing treatment.
On the other hand, if the drug is only providing minimal relief, and you’ve packed on a lot of weight, you may want to consider Risperdal withdrawal and/or pursue other treatment options. Individuals that are having a tough time evaluating the efficacy and side effects of their current treatment should discuss these concerns with a medical professional.
Did you gain weight while taking Risperdal?
Perhaps the question shouldn’t be whether you gained weight while taking the drug, it should be, “How much weight did you gain?” If you took the drug for any period of time, feel free to note how long you took it, and whether you gained weight. Be sure to mention the dosage you were taking, whether you were on other medications, and other factors that may have influenced your weight gain.
By sharing your experience, you may give someone else comfort of knowing that they are not the only one who gained weight during treatment. On a positive note, research does indicate that when you discontinue Risperdal, you should lose the weight that you gained. In other words, the weight gain associated with this medication is reversible, but does take time.