weight gain and antipsychotics

Toothbrushx2 · Nov 21, 2005

I'm not trying to be harsh, but think about what you are asking. The point of these assignments is not simply getting information about topics you've been assigned, but learning how to do lit searches and how to find the information you need so that you know how to find reliable information in the future.
There are plenty of research articles on weight gain and antipsychotics/antidepressants. If you are in school, you should have access to your school's nursing database or medline and can do a search there. You can even find good information doing a web search as long as you use sites with some professional credentials. Most of us don't keep a list of references/links on different topics handy and would have to do a search ourselves. If you don't know how to search effectively, ask your librarian for help. If your school doesn't have a health science library and you don't know how to do a search, then let me know and I'll try to help you.
Please back off from the students. You are making us nurses look bad. Thank you.

Toothbrushx2 · Nov 21, 2005

lucianne - I have already got information on the side effects of antipsychotics I was merely asking for other input from other nurses. The weight gain issue is what I am really doing. I'm new to this site, and of course dont know anyone here, and therefore I would not beable to know that references are not kept by yourselves. I do know how to complete a research, and have been doing this all a long. Research articles are released all the time and was hoping for more key words to use my searches. I appear to have received all your frustration towards students, and I'm sorry to upset people as I would never do that intentionally.
I seem to have gotton this site all wrong. Maybe I shouldn't be here. It was not so much the response that I would potentiallly get, but the contact with other student nurses and nurses. I only found this site a short time ago and I joined straight away hoping for support, friendship and guidance as we have something in common. Again I apologise for any frustrations arised. I did not read any information on the site first, I just joined straight away. I clearly see what a mistake I have made.
hsieh - thankyou for your reply it was very kind of you.

Please stay with us. Your are welcome here. Ask any question you want. Some people you just have to ignore.

mebeafrn · Nov 21, 2005

Look up the s/e of Zyprexa- it can have an insulin resistance effect. Wt. gain and blood sugars esp. in younger pt.s warrent monitoring. Hang in there:)

lucianne · Nov 22, 2005

For some reason, my point doesn't seem to be sinking in with some people. Maybe the "nice" thing to do would have been to supply an answer or references for this student. She would have had an answer (maybe correct and maybe not, depending on my level of knowledge and whether I just told her what I thought or told her what research indicates) and gone on her merry way. With the reply I gave her, she has at least learned that when she asks for help, it is usually a good idea to let the person/people she is asking know what efforts she has made on her own behalf--this applies to school, work, and pretty much every other situation in the real world. She may not have liked my reply, but better to get it online than face-to-face. What people seem to keep overlooking is that I said IF she didn't have access to a good database and IF she didn't know how to do a good search, I'd be glad to try and help her. I do understand that she was excited about finding this forum and probably posed her question without thinking through exactly what she wanted to ask. The OP did come back and clarify that she was looking for some keywords to help with her search--which I did give her.

When you are precepting, do you do a procedure for your student or orientee, or do you find out how much they know and let them do it themselves if they're able, stepping in to help only if they need it?

As a nurse, do you do for your patients the things they can do for themselves or do you save your help for what they can't do for themselves? If you do for them what they can do for themselves given their current level of functioning--and taking into consideration the need to conserve their energy--you are NOT providing good nursing care. The patient may love you for all that you do for them, but it isn't necessarily in their best interest.

When I am precepting, I supply the answer to a question that my student has if it is needed right away for some reason. If it is a question that can wait for an answer, I let them find the answer for themselves or tell them where to look if they don't know. I believe that knowing where to find (accurate) information is much more useful than just being handed the answers. If the question is about something not likely to be found in a book or journal article, I will give the student my opinion or experiences.

I've said all I have to say on the subject and will not be responding to any further comments on my replies to the OP.

lovinghands · Nov 22, 2005

For some reason, my point doesn't seem to be sinking in with some people.
I am subscribed to this thread as I'm interested in antipsychotic s.e. I deal with these meds on a daily basis and am always looking for new info. This was a great topic which could have brought forth multiple opinions and links for caregivers. Unfortunately this thread has been hijacked by opinions on teaching/precepting styles.

Toothbrushx2 · Nov 22, 2005

For some reason, my point doesn't seem to be sinking in with some people. Maybe the "nice" thing to do would have been to supply an answer or references for this student. She would have had an answer (maybe correct and maybe not, depending on my level of knowledge and whether I just told her what I thought or told her what research indicates) and gone on her merry way. With the reply I gave her, she has at least learned that when she asks for help, it is usually a good idea to let the person/people she is asking know what efforts she has made on her own behalf--this applies to school, work, and pretty much every other situation in the real world. She may not have liked my reply, but better to get it online than face-to-face. What people seem to keep overlooking is that I said IF she didn't have access to a good database and IF she didn't know how to do a good search, I'd be glad to try and help her. I do understand that she was excited about finding this forum and probably posed her question without thinking through exactly what she wanted to ask. The OP did come back and clarify that she was looking for some keywords to help with her search--which I did give her.
When you are precepting, do you do a procedure for your student or orientee, or do you find out how much they know and let them do it themselves if they're able, stepping in to help only if they need it?
As a nurse, do you do for your patients the things they can do for themselves or do you save your help for what they can't do for themselves? If you do for them what they can do for themselves given their current level of functioning--and taking into consideration the need to conserve their energy--you are NOT providing good nursing care. The patient may love you for all that you do for them, but it isn't necessarily in their best interest.
When I am precepting, I supply the answer to a question that my student has if it is needed right away for some reason. If it is a question that can wait for an answer, I let them find the answer for themselves or tell them where to look if they don't know. I believe that knowing where to find (accurate) information is much more useful than just being handed the answers. If the question is about something not likely to be found in a book or journal article, I will give the student my opinion or experiences.
I've said all I have to say on the subject and will not be responding to any further comments on my replies to the OP.

Good!!!!!!!!!!!!!!

Thunderwolf, MSN, RN · Nov 23, 2005

Like there are certain teachng styles, we also need to be mindful of certain posting styles. Many have experience in board posting....but, many do not. I appreciate all posters who help educate one another. I really do. But, one thing to consider is that a particular teaching style may not translate well from the face-to-face to the board here. I also try to mindful of this for myself. However, we always want to encourage learning and the pursuit of knowledge amongst us members. Some are more knowledgeable than others....that is why new folks join...to learn from us. We just need to be sensitive how we present ourselves and the material. Also, we can learn for ourselves what style of teaching may need to be tweaked in order to become more effective here. We learn too. It is a two way street. The message is ONLY effective IF it is heard. So, if we are trying to educate and further other members' knowledge base, we need to be sensitive to the message. On the board, without the face-to-face, erroring on naivete may be more effective. Just my take on it.

Thunderwolf, MSN, RN · Nov 23, 2005

Again, to help us refocus, the OP asked about weight gain and antipsychotics/antidepressants. Other feedback for those who can share on this topic? What information have you found that relates to this?

lsyorke, RN · Nov 25, 2005

Another aspect of ssri's and weight gain is the elevation of the cortisol levels.(elevate serotonin, increased adrenalin, increased cortisol) My experience with alot of paxil users.. and withdrawal is that the weight will stay on regardless of diet and exercise.(paxil appears to follow the one pound/mg formula). Weight loss after withdrawing from paxil is slow to start and then at the one year mark is consistently dramatic. My son gained 50 pounds on paxil(50mg) and now 18 months off paxil has lost every pound plus 10 more with no change in diet or activity. For those that have had cortisol levels checked while on paxil they are significantly elevated across the day. Just one more factor in weight gain.

GalRN · Nov 27, 2005

As a psych nurse, I have seen many pts leave my unit after a stay of several weeks 30lbs heavier than when they came in. In most cases this was due to Zyprexa or Depakote.

I have personal experience w/ this too. I'm bipolar and tried several med combos before I found the best one for me. I am 5' 9" and generally weigh around 125lbs when I am healthy. Yes, that's skinny, but my whole family has a very fast metabolism.

I took Depakote for a year or 2, and my weight went from 125lbs to 165lbs. I took the ER formulation, and noticed that about 90 min after I took it I got the "carb munchies". At one point I was eating 1/2lb bar of Hersheys w/ a quart of milk every day. Normally I'd be able to eat even more crap than that and burn it off w/o exercise, but the depakote not only made me hungry, it must've slowed my metabolism. When I switched meds (not b/c of wt gain) I lost the weight at a startling rate of about 15lbs a month w/o dieting or changing eating habits. I now take lithium, which has not affected my weight, and a low dose of Seroquel (for sleep), also not affecting my weight.

My step sister is a chronic schizophrenic (for 20+ yrs now) and she says she's never met an antipsychotic that didn't make her fat. She is now a type 2 diabetic.... but her Geodon keeps the voices away, and she's grateful.

leslie :-D · Nov 29, 2005

my 16 yo dtr is currently in a psyche hospital; this is her 6th hospitalization in 8 months. her current psychiatrist (in the hospital) dc'd 3 of her meds and started her on 20 mg of zyprexa. her appetite is now insatiable. last week she asked me if she was gaining weight and i gently told her " a little bit, sweetheart". she's extremely self-conscious about her body and she did not take my response well at all. yet i haven't told her it's the zyprexa that's doing it because she'd refuse to take it once discharged. but in the hospital, she's gained around 10 lbs in 2 weeks. i have a meeting w/her doctor tomorrow, to tell him i hate the zyprexa (i haven't seen a big change in her mental status/bipolar) and to start seroquel, preferably 300-400 mg qhs. but all the nurses have told him i'm not happy at all with her lack of progress but so far it has fallen to deaf ears. but i can attest that zyprexa does indeed increase one's appetite and if my dtr finds out, she will become so non-compliant and start using/drinking again if she's not properly medicated. it's really quite frustrating when a doctor doesn't listen to a parent.

leslie

Thunderwolf, MSN, RN · Nov 29, 2005

Sorry to hear about the daugter's weight gain. Yes, Zyprexa is well known to pack on the pounds. I also hear your frustration about not feeling understood. I've read your past posts regarding daughter and the struggles you've had. Hugs to you. You've been through alot. Hope things improve. By the way, your daughter is very fortunate to have you by her side.