Weight Gain and Side Effects of Aripiprazole and Fluoxetine

Q: Weight Gain and Side Effects of Aripiprazole and Fluoxetine

Hello, netizen： <br>1. <br>I would like to ask the doctor, does weight gain caused by a medication like Aripiprazole lead to localized fat accumulation similar to the moon face and buffalo hump caused by steroids, or is it just a general increase in weight? Additionally, if someo

Consultation on the side effects of Amway tablets and Paxil?

Dear Dr.
Wu,
I have been suffering from obsessive-compulsive disorder (OCD) for seven years.
When I am doing well, I have almost no symptoms, but during episodes, I experience bothersome intrusive thoughts.
I am currently taking 20 mg of fluoxetine (originally four capsules a day, but my doctor reduced it to two capsules recently as my condition improved) and 10 mg of aripiprazole (taking half a tablet daily).
I would like to ask you about my concern that aripiprazole seems to be causing weight gain.
Although my doctor mentioned that this medication is one of the less weight-gain-inducing options, it still appears to be making me gain weight.
When I first developed OCD as a teenager, my symptoms were more severe.
I took aripiprazole regularly, and after about 1-2 years, my symptoms improved significantly, allowing me to stop the medication for a while.
However, when my intrusive thoughts returned and I resumed taking aripiprazole, I noticed signs of weight gain.
Since then, I have had intermittent use of aripiprazole, and each time I restart, it seems to lead to weight gain, which makes me quite resistant to taking this medication.
1.
I would like to ask if the weight gain caused by aripiprazole is similar to the localized fat accumulation seen with steroids, such as moon facies and buffalo hump, or is it simply a general increase in weight? Additionally, if someone tends to gain weight on this medication, will stopping it lead to improvement? Is the degree of weight gain related to the dosage?
2.
I have recently started exercising and am wondering if, despite the potential weight gain from the medications, I can still achieve a toned physique through training and dietary control.
3.
Lastly, I would like to inquire whether the two medications I am using could lead to gynecomastia in males.
Is the likelihood high?
I apologize for the numerous questions, and I appreciate your time in addressing my concerns when you have the opportunity.
Thank you! Wishing you all the best and good health.
Best regards.

Mr. Paul, 20~29 year old female. Ask Date: 2021/10/08

Dr. Wu Enliang reply Psychiatry

Hello, netizen:
1.
I would like to ask the doctor, does weight gain caused by a medication like Aripiprazole lead to localized fat accumulation similar to the moon face and buffalo hump caused by steroids, or is it just a general increase in weight? Additionally, if someone does gain weight, will it improve after stopping the medication? Is the degree of weight gain related to the dosage?
A: No.
In fact, weight gain is very rare; one should first consider whether they are eating too much or exercising too little.
If the weight gain is indeed caused by the medication, it will improve after discontinuation.
If it does not improve, then it is likely due to other reasons.
If the medication is the cause, then it is related to the dosage.
2.
I have recently started working out and am wondering if, despite the potential weight gain from the medication, I can still achieve a toned physique through exercise and dietary control?
A: Yes, you can.
3.
I would also like to ask the doctor if the two medications I am using could cause gynecomastia in males? Is the likelihood high?
A: I have not heard of such issues.

Dr.
Wu Enliang

Reply Date: 2021/10/08

More Info

Hello! Thank you for your detailed questions regarding the medications Aripiprazole (known as 安利錠 in Chinese) and Fluoxetine (百憂解). I appreciate your openness about your experiences with obsessive-compulsive disorder (OCD) and the concerns you have regarding weight gain and other side effects. Let’s delve into your questions one by one.

1. Weight Gain and Body Fat Distribution
Aripiprazole is an atypical antipsychotic that is often used to treat conditions such as schizophrenia, bipolar disorder, and as an adjunct in major depressive disorder. While it is generally considered to have a lower risk of weight gain compared to other antipsychotics, some individuals may still experience weight gain as a side effect. This weight gain is typically more generalized rather than localized, meaning it does not usually cause specific fat deposits like those seen with corticosteroids (which can lead to moon facies or buffalo hump).
The extent of weight gain can vary significantly from person to person and can be influenced by factors such as dosage, duration of treatment, individual metabolism, and lifestyle factors. If you notice weight gain while on Aripiprazole, it is advisable to discuss this with your physician. They may consider adjusting your dosage or switching to another medication if the weight gain is significant and concerning.

When it comes to stopping the medication, many patients find that weight gain can improve after discontinuation, but this is not guaranteed. It’s essential to approach any medication changes under the guidance of a healthcare professional.

2. Fitness and Weight Management
Engaging in regular exercise and maintaining a balanced diet can certainly help manage weight, even while on medications that may contribute to weight gain. Strength training and cardiovascular exercises can improve muscle mass and overall body composition, which may counteract some of the weight gain effects of medications. It’s important to create a sustainable fitness routine that you enjoy, as this will help you stick with it long-term.

Additionally, monitoring your caloric intake and ensuring you are eating a balanced diet rich in whole foods can also support your weight management goals. Consulting with a nutritionist or dietitian can provide personalized guidance tailored to your needs.

3. Risk of Gynecomastia
Regarding your concern about the potential for gynecomastia (the development of breast tissue in males), both Aripiprazole and Fluoxetine can have hormonal effects, but the risk is generally considered low. Gynecomastia is more commonly associated with other antipsychotics, particularly those that have a stronger influence on prolactin levels. Aripiprazole is known to have a lower propensity for increasing prolactin compared to other antipsychotics, which may reduce the risk of developing gynecomastia. However, individual responses can vary, and it’s essential to monitor any changes and discuss them with your healthcare provider.

Conclusion
In summary, while Aripiprazole and Fluoxetine can lead to weight gain in some individuals, the effects can vary widely. Engaging in regular exercise and maintaining a healthy diet can help manage weight effectively. If you have concerns about side effects, including weight gain or gynecomastia, it is crucial to have an open dialogue with your healthcare provider. They can help you weigh the benefits of your current treatment against the side effects and make any necessary adjustments to your medication regimen.

Thank you for your thoughtful questions, and I wish you all the best on your journey to managing your OCD and overall health!

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