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Default Oct 24, 2019 at 07:46 PM
  #1
Today my psychiatrist gave me a prescription for 1,000 mg (500x 2 per day) Metformin. He heard a lot of success stories about it for relief of antipsychotic-related metabolic issues (and weight loss help) during his past psychopharmaceutical conferences. We both knew it had been used for these purposes for years, but he had been reluctant to prescribe it until now.

I have had a lot of trouble losing weight on my current dose, and unfortunately my current dose seems to be the dose I'll likely need long-term. My current mix is working great, so why change my mix?

I am overweight, but not severely. About 18 lbs above the high end of my normal BMI. However, I have had high cholesterol for years now and sometimes also high triglycerides. My blood pressure isn't bad, but has increased a bit. I haven't been pre-diabetic for 9 years.

My GP has continued to avoid prescribing a statin for my cholesterol. He just continues telling me to lose weight and exercise to lower it. He obviously doesn't take 600 mg Seroquel XR! I doubt he "gets it" and I imagine he wouldn't fully approve of the Metformin. However, if I can lose some weight and lower my cholesterol by February (when I see him next) he may not have a good argument against it.

Any experiences here with Metformin? Please share.
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Default Oct 24, 2019 at 07:55 PM
  #2
I'm on it for that reason, it hasn't done anything for losing weight tho. I have the metabolism of a manatee so it would be a starvation diet that might help or might just lower my metabolism lower yet! But my blood labs do all come back normal so it's helped with that.

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Default Oct 24, 2019 at 08:57 PM
  #3
A manatee. Thats it, exactly. Its not menopause, its more like, our change of life, like from caterpillar to butterfly, goes from cougar to manatee.
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Default Oct 24, 2019 at 10:20 PM
  #4
Thanks for sharing!

Nammu, I will be very happy if it improves my blood work results. Weight loss would be just an extra bonus. I'm glad that at least your blood work improved.
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Default Oct 24, 2019 at 10:52 PM
  #5
Birdie, I hope and pray it works for you. The esteemed Dr. W., my dipshite pdoc, won't address the metabolic syndrome mess I'm in. My GP tells me EXERCISE. It doesn't matter how little I eat, or how much I've exercised; Seroquel has wrecked my metabolism and caused immense weight gain, high bp, high cholesterol, higher glucose.

It's ridiculous that GP's don't pay attention to metabolic syndrome - it's ignorant of them not to.

Anyway, I'm sorry...I went off on a tangent. I do not have any direct experience with Metformin. My sister is not overweight (no metabolic syndrome), but her glucose was high so her (open-minded) GP prescribed Metformin. She took it for about 6 months and her glucose did go down. She decided to stop taking it, however, because it was causing her hair to thin.

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Default Oct 25, 2019 at 06:48 AM
  #6
I totally agree with you, BethRags, that many GPs just don't "get" our unique situations taking antipsychotics.

My stomach was a little funny last night, but not severely. I can't be sure if the Metformin played any part in that.
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Default Oct 25, 2019 at 07:41 AM
  #7
If it was just for the weight loss I would say look back through your physical check in posts. You did really great when you were planning out all of your meals. Your losses weren't huge, but they were consistent and normal. Adding an exercise regimen would probably speed things up even more. You've been blessed with what sounds like good physical health, so getting more active isn't out of the question.

If the meds offer benefits other than the weight loss I suppose it is something to consider. I just know you are pretty stable on your current cocktail and I'd be hesitant to potentially cause a shift there if you could address these issues in other ways. Just my two cents. I go out of my way to handle things naturally though. I don't even take Advil for headaches

My sister in law took it while pregnant and it caused her to have loose stools constantly, so there's that...
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Default Oct 25, 2019 at 09:22 AM
  #8
Thanks, fern! I have also noticed the rumblings relating to diarrhea this morning. It's not that bad, though. If it turns into "accidents" or very uncomfortable feelings, that would be something else.

My current med mix is the best I have ever been on, and my 600 mg Seroquel XR really seems here to stay. Thank you for recognizing my efforts to watch my eating. Sometimes, however, it's a lot harder than I might let on. At lower doses of Seroquel I do make some positive progress, but the lower dose periods are fleeting and regaining losses is usual for me. I do give myself credit for not gaining massive amounts, but my blood work is a real stubborn issue for me.

I don't quite have the right words to describe how hard it can be to take up a regular exercise regimen for me. In my younger years, it was an easy part of my life. Fern, I am on disability for a reason. There are a number of things I used to be able to do that I haven't been capable of for years. And no, it's not all the medications' fault. Why some people diagnosed with bipolar disorder can be stereotypically high functioning and others not is a bit of a mystery to me. Again, I used to be somewhat stereotypically high functioning in most ways up until about 31 years old. Then it became increasingly difficult. That's even before I took any meds. [And I, too, rarely even took a Tylenol.] On the right meds, I am much more functional in ways that I wasn't for quite a while. I feel that I am a significantly better person now than ever. I'm going to say that knowing my situation well, a med-free life just isn't in the cards for me... perhaps forever. Again, it's hard to explain why I know that. My statements are not cop outs. They are realistic thinking.

I know how much you suffered because of your severe psychotic episode. Imagine multiplying that by 20 or more. Frankly I really can't come up with a true count. Again, it's hard to describe why trying something like Metformin is so welcome right now for me. It's hard to give detailed answers why some people can achieve goals without "unnatural" crutches. There are times when not taking advantage of such tools, but rather saying "This is the 'right way' or only 'proper way'" is a set up for potential constant failure. A fool's errand. It's similar to many people saying "I can fight bipolar myself without meds" or "I can cut down on drinking on my own" when it can never be true. For some possible? Yes. But not all. No amount of praying to God will do it for me. As Einstein said "Doing the same thing over and over and expecting different results is insanity."

I'm trying something new here. Will it work out? I don't know, but I am giving it a try. If it doesn't work, I'll try something else.

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Default Oct 25, 2019 at 10:11 AM
  #9
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Originally Posted by BirdDancer View Post
Thanks, fern! I have also noticed the rumblings relating to diarrhea this morning. It's not that bad, though. If it turns into "accidents" or very uncomfortable feelings, that would be something else.

My current med mix is the best I have ever been on, and my 600 mg Seroquel XR really seems here to stay. Thank you for recognizing my efforts to watch my eating. Sometimes, however, it's a lot harder than I might let on. At lower doses of Seroquel I do make some positive progress, but the lower dose periods are fleeting and regaining losses is usual for me. I do give myself credit for not gaining massive amounts, but my blood work is a real stubborn issue for me.

I don't quite have the right words to describe how hard it can be to take up a regular exercise regimen for me. In my younger years, it was an easy part of my life. Fern, I am on disability for a reason. There are a number of things I used to be able to do that I haven't been capable of for years. And no, it's not all the medications' fault. Why some people diagnosed with bipolar disorder can be stereotypically high functioning and others not is a bit of a mystery to me. Again, I used to be somewhat stereotypically high functioning in most ways up until about 31 years old. Then it became increasingly difficult. That's even before I took any meds. [And I, too, rarely even took a Tylenol.] On the right meds, I am much more functional in ways that I wasn't for quite a while. I feel that I am a significantly better person now than ever. I'm going to say that knowing my situation well, a med-free life just isn't in the cards for me... perhaps forever. Again, it's hard to explain why I know that. My statements are not cop outs. They are realistic thinking.

I know how much you suffered because of your severe psychotic episode. Imagine multiplying that by 20 or more. Frankly I really can't come up with a true count. Again, it's hard to describe why trying something like Metformin is so welcome right now for me. It's hard to give detailed answers why some people can achieve goals without "unnatural" crutches. There are times when not taking advantage of such tools, but rather saying "This is the 'right way' or only 'proper way'" is a set up for potential constant failure. A fool's errand. It's similar to many people saying "I can fight bipolar myself without meds" or "I can cut down on drinking on my own" when it can never be true. For some possible? Yes. But not all. No amount of praying to God will do it for me. As Einstein said "Doing the same thing over and over and expecting different results is insanity."

I'm trying something new here. Will it work out? I don't know, but I am giving it a try. If it doesn't work, I'll try something else.
Woah BirdDancer... I feel as if you've made a couple of assumptions here about my statements that I don't really resonate with. I was responding to you staying 'My current mix is working great, so why change my mix?' and that you've mentioned previously you're in fairly good physical health.

I have always supported you and anyone else here in taking thier meds. I agree they are a necessary method for many and they are the very reason why some people are able to achieve any sort of stability at all. You'll get no argument on that from me. I simply wanted to support you if you were considering trying to tackle things on your own since you had success in the past. If it isn't an option and you'd rather try a med I think that's great too. You responded as if you believe I'm judging you. I'm not. I'm always impressed at how you handle yourself and I wholeheartedly trust you and only you know what's best for you.

I also assume anyone who is on disability is so for a reason. I do not view that as a choice someone would take on lightly or for any other reason than they need it to live. It seems like a difficult road.

I hope the new mix works out for you. As always, I wish you nothing but the best.
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Default Oct 25, 2019 at 10:40 AM
  #10
Hi @fern46 I'm sorry I went off on such a tangent and read something in your post that wasn't really there. I have a bad sinus headache this morning and guess I am not thinking as clearly as usual. Also, mood-wise I am OK, but stress has been present even when seemingly "hidden" even to myself. I have a tendency to do that sometimes as a survival/relief mechanism. Unfortunately, something sometimes "gives" in inappropriate ways.

I am generally well in many ways, but have been quite frustrated with my high cholesterol for longer than I'd like. I'm going to give this Metformin a try. We'll see how it works out.

I apologise again. I very much value your responses to my posts and hope the above doesn't deter you from responding to them in the future. Thank you for drawing my attention to this. :throb
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Default Oct 25, 2019 at 10:47 AM
  #11
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Originally Posted by BirdDancer View Post
Hi @fern46 I'm sorry I went off on such a tangent and read something in your post that wasn't really there. I have a bad sinus headache this morning and guess I am not thinking as clearly as usual. Also, mood-wise I am OK, but stress has been present even when seemingly "hidden" even to myself. I have a tendency to do that sometimes as a survival/relief mechanism.

I am generally well in many ways, but have been quite frustrated with my high cholesterol for longer than I'd like. I'm going to give this Metformin a try. We'll see how it works out.

I apologise again. I very much value your responses to my posts and hope the above doesn't deter you from responding to them in the future. Thank you for drawing my attention to this. :throb
No worries at all! We are friends and we both handled this like friends would. I'd want you to call me out if I offended you. I just wanted you to know I fully support you and will continue to do so. You've always done the same for me!

I am very hopeful for you that you will get some relief from your symptoms from this change!

Conflict doesn't scare me. It is healthy sometimes and makes everyone think. It did that for me here. Thank you for a good conversation
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Default Oct 25, 2019 at 12:19 PM
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No worries at all! We are friends and we both handled this like friends would. I'd want you to call me out if I offended you. I just wanted you to know I fully support you and will continue to do so. You've always done the same for me!

I am very hopeful for you that you will get some relief from your symptoms from this change!

Conflict doesn't scare me. It is healthy sometimes and makes everyone think. It did that for me here. Thank you for a good conversation
Thank you, my friend
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Default Oct 25, 2019 at 04:03 PM
  #13
I really have had good experiences with metformin. First, did he give you XR? That cuts down on the diarrhea drastically.

I've been on 500 mg/day for 3 years. At first it made it easier to lose about 20 lbs that I had gained since starting clozapine. Then it helped keep the weight off. My blood sugar came down from borderline to really good. I think my cholesterol came down too but I don't remember that; I just know I'm not on meds for it and I think I was near needing them before metformin.

Over time I lost another 10 lbs, so down 30 from when I started it.

Since I've been sick and eating so many carbs because they are the only thing I can digest safely I've gained 10 lbs back. Hopefully I'll feel well enough to eat normally or find some approximation of normal soon. This carb fest can't continue; I will not gain all that weight back.

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Default Oct 25, 2019 at 04:23 PM
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I really have had good experiences with metformin. First, did he give you XR? That cuts down on the diarrhea drastically.

I've been on 500 mg/day for 3 years. At first it made it easier to lose about 20 lbs that I had gained since starting clozapine. Then it helped keep the weight off. My blood sugar came down from borderline to really good. I think my cholesterol came down too but I don't remember that; I just know I'm not on meds for it and I think I was near needing them before metformin.

Over time I lost another 10 lbs, so down 30 from when I started it.

Since I've been sick and eating so many carbs because they are the only thing I can digest safely I've gained 10 lbs back. Hopefully I'll feel well enough to eat normally or find some approximation of normal soon. This carb fest can't continue; I will not gain all that weight back.
Thanks for sharing your experience, BeyondtheRainbow! So positive!

I'm on the regular, but will keep in mind your feedback about the XR. I had a little diarrhea yesterday, but nothing major. It's likely too soon for me to know. I'll monitor that and any other side effects that seem related to Metformin.

So you do well on just 500 mg? I'm prescribed 1,000 mg. If 500 mg would be sufficient, I'd rather take less. I'll keep that in mind, too.

I've been doing some research on Metformin and read that it is contraindicated for people with certain levels of kidney damage. I checked my recent creatinine levels and they are lower than the ones mentioned, but I nevertheless left a message on my psychiatrist's voicemail about this. I do have elevated creatinine. I may need to call my nephrologist or even ideally perhaps my psychiatrist should if he sees an issue. We'll see. I'm not panicking about it.

I will say that when it comes to psychiatrists prescribing certain meds, some GPs and other doctors can get a bit frustrated, though I know psychiatrists prescribe various meds beyond typical psych ones (i.e. propranolol, Synthroid, Metformin, etc.) I'm a little worried about what my GP's view would be on this. Long story. I know doctors often criticize other doctors. Believe me!
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Default Oct 25, 2019 at 04:57 PM
  #15
Metformin really helped me, GP had me stop taking it once my A1C got back into the normal range (which it did). Didn't make me lose any weight, but did give me diarrhea, especially when I ate anything sugary. I would urge you to avoid eating grapes, since they seem to be particularly high in fructose and thus diarrhea-causing on Metformin.

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Default Oct 25, 2019 at 05:01 PM
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My family dr prescribes mine. I'm only on 500 mg because my blood sugar is not high and he doesn't want me to pass out. He did say I could take 1000 mg if I checked my sugars a few times per week. At that time I decided to just stick with 500 mg. With the recent changes in my health I may reconsider.

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Default Oct 25, 2019 at 05:33 PM
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Metformin really helped me, GP had me stop taking it once my A1C got back into the normal range (which it did). Didn't make me lose any weight, but did give me diarrhea, especially when I ate anything sugary. I would urge you to avoid eating grapes, since they seem to be particularly high in fructose and thus diarrhea-causing on Metformin.
Thanks for the tips about the sugary stuff. That's tough since I like my sweets. I can easily avoid the grapes.
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Default Oct 25, 2019 at 05:42 PM
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Thanks for the tips about the sugary stuff. That's tough since I like my sweets. I can easily avoid the grapes.
It's all about portion control. You can eat sugar cubes if you want, just not very many.

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Default Oct 25, 2019 at 05:43 PM
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Thanks, everyone, for all of your feedback and experiences on this! I just received a return call from my psychiatrist telling me to stop taking the Metformin. I had left a message on his voicemail telling him what I read about the contraindications relating to kidney damage.

After receiving my message, he did a little much-needed extra research himself. He had access to extra blood work results information for me that I was not aware of. Apparently, he should have done a bit more checking on this before prescribing it for me. His boo-boo! He apologized. It goes to show how important it can be sometimes to do a bit of your own research. I assume he's learned a little lesson, too.

I actually don't feel that well at all right now. I'm not certain that it's related to Metformin, though. I have had what feels like a bad sinus headache most of the day. If it is related to Metformin, another
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Default Oct 25, 2019 at 06:10 PM
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Thanks, everyone, for all of your feedback and experiences on this! I just received a return call from my psychiatrist telling me to stop taking the Metformin. I had left a message on his voicemail telling him what I read about the contraindications relating to kidney damage.

After receiving my message, he did a little much-needed extra research himself. He had access to extra blood work results information for me that I was not aware of. Apparently, he should have done a bit more checking on this before prescribing it for me. His boo-boo! He apologized. It goes to show how important it can be sometimes to do a bit of your own research. I assume he's learned a little lesson, too.

I actually don't feel that well at all right now. I'm not certain that it's related to Metformin, though. I have had what feels like a bad sinus headache most of the day. If it is related to Metformin, another
I'm sorry it didn't work out. It's so great you did the research and knew to ask. You set a wonderful example! I hope you feel better tomorrow
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