lori4taz

Aripiprazole (Abilify) and weight gain after sleeve gastrectomy

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Wondering if I will be able to continue on my Abilify 2.5mg after my sleeve because of weight gain factor. It has been necessary to control my bipolar, and there are no other meds that do not have the weight gain factor

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Dear Lori,

 

It is extremely important that your bipolar symptoms be well controlled. If aripiprazole (Abilify) works well, you should plan to continue to take it after your sleeve gastrectomy. You and your psychiatrist may need to change the dose depending on how well it is absorbed and how your weight loss changes your response to the drug. It is annoying that Abilify seems to make you gain weight, but hopefully that will not be too big a factor after your surgery. Even if the surgery is not quite as effective with Abilify on board, you still will be much better off overall at a lower weight.

 

I've attached an interesting review article that ranks the various newer psychological medications by their tendency to cause weight gain. Fortunately, aripiprazole is relatively low on the list. It causes a lot less weight gain than many other medications.

 

Dr. Callery

 

 
Expert Opin Drug Saf. 2015 Jan;14(1):73-96. doi: 10.1517/14740338.2015.974549. Epub 2014 Nov 15.
Weight gain and antipsychotics: a drug safety review.
Abstract
INTRODUCTION: 

Second-generation antipsychotics (SGAs) are widely used in several psychiatric disease entities and exert to a different extent a risk for antipsychotic-induced weight gain (AIWG). As AIWG is associated with an increase in metabolic syndrome or cardiovascular events, knowledge of these risks is crucial for further monitoring and the initiation of counteractive measures.

AREAS COVERED: 

We searched PubMed and Web of Sciences for randomized-controlled trials and naturalistic observational studies published between 2010 and 2014 with sample sizes exceeding 100, including all marketed SGAs apart from zotepine, and providing data on weight increase. We also summarized relevant systematic reviews and meta-analyses of head-to-head comparisons.

EXPERT OPINION: 

Recently published data still support the hierarchical ranking of SGAs already proposed in previous reviews ranking clozapine and olanzapine as having the highest risk, followed by amisulpride, asenapine, iloperidone, paliperidone, quetiapine, risperidone and sertindole in the middle, and aripiprazole, lurasidone and ziprasidone with the lowest risk. Number needed to harm varied considerably in our meta-analysis. Younger patients and patients with a lower baseline body mass index are most vulnerable. The greatest amount of weight gain occurs within the first weeks of treatment. AIWG occurs in all diagnostic groups and is also common in treatment with first-generation antipsychotics; therefore, awareness of this adverse event is essential for anyone prescribing antipsychotics.

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