Bipolar Disorder Meds and Metabolic Syndrome

Drugs Can Raise Risk of Metabolic Syndrome and Type 2 Diabetes

Woman with bipolar disorder. Credit: Peter Dazeley / Getty Images

Many of the medications used to manage bipolar disorder are thought to contribute to the risk of developing metabolic syndrome and type 2 diabetes. These are both chronic conditions that require ongoing medication and treatment, so the right choice of drugs is important to lessen the risk of diabetes if you have bipolar disorder.

Metabolic syndrome is a collection of conditions, including insulin resistance, that can often lead to a diagnosis of type 2 diabetes if it is not reversed with diet and exercise. Obesity and inactivity are prime risk factors for metabolic syndrome, and are things that you can change to lessen your risk. Sometimes factors beyond our control may cause metabolic syndrome, such as certain of the drugs prescribed to manage bipolar disorder.

Bipolar disorder is a medical condition with symptoms that include extremes of mood known as depression and mania. Many of the medications prescribed for bipolar disorder can place people at risk for developing metabolic syndrome. This is often called prediabetes, and it then puts you at risk for type 2 diabetes and the even greater risks that condition brings for further major health problems.

According to the online journal, Bipolar Disorders:

  • "The prevalence of the metabolic syndrome in patients with bipolar disorder is alarmingly high, as it is for the general population. The prevalence of obesity is even higher than the already very high prevalence that has been estimated for the US general population."

Some Medications for Bipolar Disorder Lead to Weight Gain and Signs of Metabolic Syndrome

Not all medications used for bipolar disorder cause metabolic symptoms but the medications listed here are more prone to causing weight gain, insulin resistance, hyperglycemia (high blood glucose levels) and other signs associated with metabolic syndrome. The National Institutes of Mental Health note that your doctor should monitor your weight, glucose levels and lipid levels regularly while on these medications.

  • Olanzapine (Zyprexa) - weight gain, hyperglycemia
  • Sodium valproate and valproic acid (Depakote) - weight gain
  • Clozapine (clozaril) - weight gain, hyperglycemia
  • Quetiapine (Seroquel) - weight gain, hyperglycemia
  • Risperidone (Risperdal) - weight gain, hyperglycemia
  • Lithium - transient hyperglycemia

Reducing Risk of Metabolic Syndrome in Bipolar Disorder Treatment

Many physicians have become aware of the implications of bipolar disorder and the accompanying medications on the development of metabolic syndrome and diabetes. According to the online journal, Psychiatric Times, of January 2007:

  • "Considering the emerging recognition of the true enormity of the metabolic consequences of bipolar disorder, drugs with an advantageous metabolic profile should be considered as first-line therapy in the long-term management of this condition."

In other words, medications that don't cause the symptoms of metabolic syndrome should be prescribed first. Only if those drugs are ineffective in treating bipolar disorder, then should the drugs that are likely to cause metabolic syndrome be prescribed. Also if patients are on those drugs, they should be monitored for weight gain, high cholesterol and insulin resistance and glucose intolerance. Diet and exercise can help reduce the risk of metabolic syndrome and can be important for people on the drugs that raise its risk.

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Article Sources

  • Bipolar Disorder, National Institute of Mental Health, accessed 2/26/2016.
  • D'Mello, MD, Dale A., Narang, MD, Supriya, & Agredano, MD, Gina (2007). Prevalence and Consequences of Metabolic Syndrome in Bipolar Disorder. Psychiatric Times. Vol. 24.
  • Fagiolini, Andrea, Frank, Ellen, Scott, John A., Turkin, Scott, & Kupfer, David J. (2005). Metabolic Syndrome in Bipolar Disorder: Findings from the Bipolar Disorder Center for Pennsylvanians. Bipolar Disorders. 7, 424-430.
  • Kelly, William J. (Ed.). (2007). In Nursing 2007 Drug Handbook (27th ed.), Ambler, PA: Lippincott, Williams and Wilkins.
  • Ness-Abramof R, Apovian CM. "Drug-induced Weight Gain," Drugs Today (Barc.) 2005 Aug;41(8):547-55.