04
Feb 25

Antipsychotic Weight Gain and Teens

Teenager“The routine helped her to get through the days, and the activity improved her mood.”

It can be heartbreaking to watch your teen put on unwanted pounds after starting a new medicine. My daughter once gained twenty pounds in one month on a new antipsychotic. It was as though her brain was no longer getting the message that she was full after eating. She would eat a meal and half an hour later be starving. This is a positive story about how a psychiatrist and his patient worked together to get her through it.

While my daughter’s psychiatrist set to work adjusting her medication, she and I began focusing on exercise. She was barely out of psychosis and had been sedentary for some months. Her psychiatrist wanted her to walk for an hour and twenty minutes a day, but the extra weight made her feel exhausted and winded.  He told us to break it into four 20-minute segments per day. Somehow, this seemed manageable to my daughter and we were able to get in a total of 80 minutes of daily walking. The routine helped her to get through the days, and the activity improved her mood.

I removed every scrap of sugar from the kitchen and replaced it with fruit, cut vegetables, and whole grain breads for when she was desperate. I reasoned that if she was going to overeat, at least it would not be calorie-rich food with no nutrition. This limited the weight gain. The psychiatrist also urged me to push high-protein, fiber-rich foods, which satisfy the appetite longer. I tried not to let her eat after dinner. Fortunately, she only had to make it to bedtime because her medicine made her fall asleep ten minutes after she took it.

Fortunately, her doctor had the problem resolved within a month. He slowly cut her offending antipsychotic with a smaller amount of the antipsychotic Geodon. The Geodon counteracted the hunger issue. The nightmare was over, but she was up twenty pounds. We continued with the walks. I took her to the Lily Pulitzer store, and I saw what a difference a well-cut garment can make in terms of flattering a heavy figure. Patterns hide a paunch better than a solid color. The tops I bought her were designed to be worn out, not tucked in, and they were sewn to glide over her hips so that it slimmed her and made it look like she had a waistline. She wore jeggings with boots and that was slimming too. I’ll never forget the day I saw her look in the mirror and smile at herself.

She lost the twenty pounds in two months. Geodon requires food to work. In fact, a couple of clinical trials suggest that 500 calories is the magic number. So I fed her a 500-calorie breakfast and dinner with her medicine, which is taken twice a day. Once we became rigorous about getting her calorie count up with each dose, the appetite-suppressing effect kicked in. Now she wasn’t hungry. She ate a light lunch, usually some low-fat cheese or turkey and a piece of fruit, along with a bottle of water. After the weight came off, it was easier for her to walk and we condensed our walking times. She began running ten minutes a day before our morning walk. When her psychiatrist ran blood work again, we held our breaths, but her cholesterol levels were the best they had been. Then something completely unexpected happened. My blood work was better than it had ever been too!


23
Jan 25

Forcing Hospitalization

MAL-doc-with-patient-IS10715539-cmyk-300_0.jpg“It is possible to force a hospitalization if your teen reaches a point where they are at risk of harming themselves or someone else.”

Sometimes parents turn to the behavioral health hospital if nothing else has worked to get through to their teen. It is possible to force a hospitalization if your teen reaches a point where they are at risk of harming themselves or someone else. The parent calls 911 and states that their teen has threatened to kill themselves or to hurt someone else. The police come, along with an ambulance, and they are taken to the hospital, where they are usually placed on a 72-hour hold.

During a forced hospitalization, the staff can sometimes get through to the teen during those three days.Be prepared for some possible anger from your teen. They may say things like, “You think so little of me that you had me locked up in a mental hospital.” Do not let your teen shift the focus from their problems to your behavior.

To prepare, enlist the aid of a family therapist beforehand and think through what you are expecting and how you plan to handle your teen’s anger. Let your teen know that you sympathize with their resentment but that you are doing this because you love them. During the time that your teen is in the hospital, see if you can negotiate a plan for recovery once your teen comes home. The hospital staff can help with this. Try to make the plan very specific so that there is no room for misinterpretation once you get home. For example, see if your teen will agree to see a therapist once a week for six months. Do not back down. You did not go this far only to let things go back to the way they were.