What strategies have you found most effective for supporting weight loss in patients with bipolar disorder while minimizing the risk of mood destabilization?

If residual depressive symptoms are present, then the addition of bupropion is helpful. If the weight gain is deemed due to necessary psychiatric medication, then the addition of metformin often works. Of course, for the management of weight, diet and exercise need to be encouraged (in addition to t...

It would be very difficult to disagree with the above opinions. We are the most obese nation on the planet, it seems. We also try to repair the most delicate and poorly understood conditions like bipolar disorder with a sledgehammer of our pills.

It is very hard to not agree with a balanced diet, wh...

I concur with the prior answers; in addition, in my practice when weight gain is a problem I strive to advise about weight loss much more than just lip service. I try to enlist the patient in making healthy body weight a priority and go into detail about motivating the patient for healthy body weigh...

I sometimes will add Topamax.

A healthy keto diet is my first recommendation but compliance with that is generally poor. GLP-1 agonists if you can hurdle the onerous PA process. I agree with Topiramate. More effective at higher dosages of 200-300 mg/day and may provide additional mood stabilization.

First, I counsel a diet high in lean protein, fruits, and vegetables. Limiting carbohydrate to one serving per meal. And absolutely no carb/fat combos (chips, cookies, etc.). The anti-psychotics make you crave that stuff. Then when you eat it, you're even hungrier than when you started. If BMI is ov...

It is a difficult situation with patients gaining weight on our meds. I would be careful adding Wellbutrin for the risk of inducing cycling. If the patient was depressed, I would try and maximize the mood stabilizer first. I like Trileptal and Tegretol and find them both to be more or less weight-ne...