Weight Gain Concerns After Long-Term Olanzapine Use: What to Expect

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Hello Dr.
Wang, I have been taking 5mg of Zyprexa (Olanzapine) every night for over a year.
My diet has remained unchanged compared to when I was not on medication, but over the past year of treatment, I have gained more than 10 kilograms, which is quite distressing.
However, my condition has been very stable, and my primary physician plans to have me discontinue the medication next month.
I would like to ask if stopping Zyprexa will allow my weight to return to normal.
How long might it take to recover? Will my basal metabolic rate return to normal levels? Additionally, I would like to know if there will be withdrawal symptoms after discontinuation (e.g., insomnia).
Thank you, Dr.
Wang.

Ms. Li, 20~29 year old female. Ask Date: 2022/08/30

Dr. Lin Mianzhang reply Psychiatry

Dear Ms.
Lee,
I hope this message finds you well.
As Dr.
Wang is no longer with our hospital, I have been asked to respond on their behalf.
Weight gain is a common side effect of olanzapine.
Generally, after discontinuing this medication, weight can gradually return to normal; however, the rate of recovery varies from person to person and may take several months.
Some individuals may not be able to return to their original weight.
There are many potential mechanisms by which olanzapine may cause weight gain, but there is currently no research regarding whether olanzapine affects the basal metabolic rate.
Typically, if olanzapine is tapered off gradually, there should not be significant withdrawal symptoms, but it is important to monitor for any signs of the original symptoms returning.
Wishing you peace and health.

Reply Date: 2022/08/30

More Info

Weight gain is a common concern for individuals taking Olanzapine (Zyprexa), a second-generation antipsychotic medication. It is known for its efficacy in treating various psychiatric conditions, including schizophrenia and bipolar disorder. However, one of the significant side effects associated with long-term use of Olanzapine is weight gain, which can be distressing for many patients.

In your case, having gained over 10 kilograms while on a stable dose of 5 mg per day for more than a year, it is understandable that you are concerned about your weight. The weight gain associated with Olanzapine is thought to be due to several factors, including increased appetite, changes in metabolism, and alterations in fat distribution. While some patients may experience weight gain, others may not, and the extent of weight gain can vary widely among individuals.

When it comes to stopping Olanzapine, many patients wonder if their weight will return to normal. The good news is that, for some individuals, weight loss can occur after discontinuation of the medication. However, the timeline for weight loss can vary significantly from person to person. Some may notice a gradual decrease in weight within a few months, while others may take longer to see changes. It is essential to understand that weight loss may not be immediate, and factors such as diet, exercise, and overall lifestyle will play a crucial role in this process.

Regarding your question about metabolic rate, there is limited research on how Olanzapine affects basal metabolic rate (BMR). Some studies suggest that weight gain may be associated with changes in metabolism, but it is not entirely clear if stopping the medication will lead to a significant increase in BMR. It is advisable to maintain a balanced diet and engage in regular physical activity to support your metabolic health during this transition.

As for withdrawal symptoms, Olanzapine is generally not associated with severe withdrawal effects, especially if the medication is tapered off gradually under the supervision of a healthcare provider. However, some individuals may experience a resurgence of their original symptoms or new symptoms, such as insomnia or anxiety, after stopping the medication. It is crucial to communicate with your healthcare provider about any concerns you have regarding discontinuation and to develop a plan that includes monitoring for any potential withdrawal symptoms.

In summary, while weight gain is a common side effect of Olanzapine, many individuals may experience weight loss after discontinuation. The timeline for weight loss can vary, and maintaining a healthy lifestyle will be essential. Additionally, while withdrawal symptoms are generally mild, it is important to work closely with your healthcare provider to ensure a safe and effective transition off the medication. If you have further concerns about your weight or the effects of stopping Olanzapine, do not hesitate to discuss them with your healthcare provider, who can provide personalized guidance based on your specific situation.

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