Is Risperdal worth the weight gain??

[mavh2005]

This is my first post, but I've been reading posts and gotten alot of ideas and insight into my difficult child.

difficult child is on .5 mg of risperdal twice a day and 1mg of Tenex at night. The risperdal has been a god send.. Wonderful results.. but her weight is getting out of control. She's gained 20 pounds since starting the medication in October. We knew this was a side effect but none of the docs were concerned because difficult child was so small. Well now she's caught up to her peers in weight and height, but I don't see her appetite slowing down. Has anyone else had this problem and what did you do?

 

[timer lady]

For my difficult child son, wm, risperdal was the one medication that helped with his rages. (My difficult child kt takes seroquel & that was a huge weight gain for kt. psychiatrist added topamax to slow down the weight gain & it worked.)

I gain weight on some of my epilepsy medications; some people do on their anti depressants. I choose to take my medications to remain functional.

It will be different with a young girl ~ this is the time to start planning & making meals together. kt & I have spent hours in the kitchen discussing portion control, drinking lots of water, snacks that are acceptable versus the killer snacks. I kept lots of yogurt, apples, carrots with ranch dressing, etc in the house for kt. I kept sweets as well & as I said above kt learned the portion control so would read the pkg to see what amt of that snack was a portion. This took a few years & it is working because I started at about your difficult children age.

We never discussed or used the word "diet". I asked kt how she felt in her clothes; if she wanted something sweet I would suggest a healthy sweet before a small candy bar or tootsie rolls. Many times she chose the apple with 1 tbsp of apple dip.

I'm sorry this is so long. I have never changed a medication that worked because of weight issues. Instead we worked on the above & self esteem issues.

Check the American Girl Library ~ there are many we used for kt at that age that helped her thru those times.

 

[gcvmom]

It's a very personal decision. In my opinion, if it is working that well for my child, then I would be willing to get a little more creative with addressing the appetite/weight issues in order to preserve the benefits of the medication. You can work on helping your child find an aerobic activity that they enjoy and are willing to do several times a week (at least 3-4). You can have your child help come up with high fiber, low calorie snack options, meal planning, etc. And a more mentally stable child may be more willing to try these different things to help keep weight and appetite in check.

For some people, they simply accept that weight is going to be the trade-off. I'm not advocating that, but I have met some adults whose illness was so bad before that now say they'd rather be stable than thin.

Compared to the other AP's like Risperdal and Abilify, we've had better results with Seroquel (at the higher dosage levels) in terms of weight and appetite staying within normal ranges.

 

[jcox]

Personally I would probably consider switching her to something else before the weight gain gets too much out of control. My E was a small four year old weighing only 35 lbs. He was put on Risperdal at that age. Within the next two years he gained 65 lbs and went from being skinny to being an obese 99 lbs at 6 y.o. His health was affected by his weight. He could no longer run, climb, jump, play with other children, ride his bike or even walk up stairs without getting tired. His little body was so tired. The Risperdal became a vicious cycle for him. He would gain weight so the Risperdal stopped working, they would raise the dose, he would gain more weight, etc. Finally it stopped working, but they could not raise it anymore. We actually tried taking him off but he got out of control with rages. It was not until he went to the psychiatric hospital last Winter that they were able to take him off switching him to Abilify and Lithium ER which work better for him, and aren't so bad on his weight. He has lost 14 lbs since his medication change. When he was admitted they did blood work and found out his triglicerides and bad cholesterol were both very high. They blamed the Risperdal on that too.

 

[KTMom91]

Miss KT didn't have the weight gain issues...still doesn't. I don't know if the Adderall counteracts it in her, or if she just has a fast metabolism, but it hasn't been a problem.

 

[slsh]

I think Timer Lady has some good suggestions about using this as an opportunity to start talking about healthy diet and portions.

For us, the weight gain was absolutely worth it. thank you went from a very skinny 8-year-old to a pretty big guy. Probably technically overweight but definitely not obese. Risperdal was the one sure medication that touched the severity of his raging - it didn't "cure" it, but the rages were less frequent and less severe most of the time.

He did turn into a real food craver - could eat a pound of salmi in 5 minutes (no joke). Really craved salt and carbs. We tried to offer healthy choices but... it didn't work so well. Even when he went into Residential Treatment Center (RTC) and had more limited access to foods, the weight stayed on.

I hadn't thought of it before, but he went off all medications in the late spring of this year. Coincidentally, he dropped about 80 pounds. I attributed it to street drugs but now I'm wondering if part of the weight loss was because he wasn't taking risperdal for the first time in 10 years.... I don't know, probably will never know the answer, but... just pondering out loud.

I think deciding if the weight gain is worth it is going to be an individual decision. We tried every atypical antipsychotic out there and Risperdal was the only thing that touched thank you's aggressiveness. Because of the level of violence that we were living with- on a daily basis, to husband and me the trade off of weight gain was well worth the benefits of the Risperdal.

 

[Running_for_the_shelter]

Wasn't for us. We saw no benefit and the weight gain and accompanying self-esteem issues were big issues. He compared himself to Augustus Gloop (the greedy kid in Charlie and the Chocolate Factory) so many times I still can't stand the sound of the name. Everything is a risk/benefit analysis. Our decision was pretty easy, but it sounds like yours isn't. You hate to mess with something that is actually working. Are your doctors concerned now? They may not have been when your difficult child was small, but they may want to do something slightly different. My difficult child packed it on while he was taking the Risperdal and lost it fairly quickly when he stopped. We hadn't gotten to the point where the doctor was worried, but I was getting bothered by the self-esteem issues. Good luck!

 

[Marguerite]

difficult child 1 doubled his weight in six months, when he began risperdal. He was only taking quarter of a tablet, too. Once a day, before bedtime. We took him off it eventually because the benefits were just too minimal. We left difficult child 3 on it for a lot longer - he didn't really gain weight although it must have had an effect, when we took him off risperdal (because the benefit was just not enough to justify the cost) he lost a little weight.

difficult child 1 also lost weight when he came off risperdal - it came off slowly, he didn't lose all the weigt because in the meantime he had grown taller and filled out a little in the chest. But he's back to being thin andwiry, not an ounce of spare fat on him anywhere.

difficult child 3 is also a stick - if you saw that film clip I posted a fortnight ago with his TV interview, you will see a very thin kid.

What I'm saying here - we only took our kids off it because the benefit was minimal. When we did, the weight gain reversed.

Any ongoing weight problems are probably ones the person would have had anyway for other reasons.

However, teaching helathy eating is a good idea - that, and exercise. Personally I would enjoy the benefits and as gthe child matures (and learns more self-control) then consider reducing the dose to a point where you can still get some benefit from the medications without as much of the problem.

Marg

 

[mavh2005]

We keep healthy foods and snacks available for difficult child to eat.. but of course when she's at her BM's its junk food all the time.

But now we might have a bigger problem.. the teacher is complaining that difficult child is now falling asleep in class. Not sure if its the medication combo or if its due to her home situation at BM's. I can't wait until Monday's parent teacher conference.

 

[Marguerite]

Risperdal can be very sedating. We had to take difficult child 1 off all daytime medications, because he would take it then an hour later would be sound asleep. difficult child 3 didn't have this problem even though he is ten years younger and was on three times the dosage of his brother.

It varies form child to child, as to how much it sedates. You might need to reduce the morning dose or even cut it out entirely.

As for the junk food - of course it's not as good for them, but this would be an issue anyway even if the child were not on risperdal. Once the risperdal is stopped, any weight gained will begin to fall off (or get taken on board as normal growth). The added appetite stimulant effect goes when the medications stop. But a kid always needs good eating habits to be encouraged. You just do the best you can and try to not stress about what you can't change.

Marg

 

[Fran]

Risperdal was the single most effective medication that difficult child used. We were willing to live with the weight issues. He continues to have weight issues and is not willing to address them.
He isn't violent and he isn't removed from his home so it is worth it.
I wish I could help him lose weight but that is the basket B to us.

 

[wakeupcall]

Risperdal worked very well for my difficult child. However, it wasn't worth the weight gain. All I could do is envision the additional problem of an obese child. He loved eating all the time and his choices were horrible no matter what my suggestions were (don't you know that mothers don't know a thing??) I keep the medication around for an emergency rage medication, but haven't used it.

 

[Christy]

Risperdal has been a lifesaving medication for our difficult child. His tantrums, destruction and violence made it impossible for him to stay in our home. After a fourth psychiatric hospital stay, the doctor put him back on risperdal (He'd been on it several years ago.) and the difference was night and day. He is doing remarkably well now and so for us, the weight gain and potential health problems that could result are worth it. I do worry though. He has gained a moderate amount of weight (He weighed 85 pounds when he began the taking it in May and now weighs 105 pounds in December). You wouldn't consider him fat to look at him but his whole body shape has changed. He used to be so lean his jeans hung on his hips and now his has a small gut. He has also gained quite a bit of weight through his thighs and actually has stretch marks on his hips and thighs. He went from being fit looking to kind of "doughy". We have tried to become more physically active as a family, keep healthy foods on hand as well as the junk food, and I buy a lot of different flavors of sugarless gum for him to chew when he is hungry but has already eaten enough. We try to get the point across that even though he feels hungry, he doesn't always need to eat and should try to distract himself from eating by doing other things. Sometimes it works and sometimes being hungry makes him really angry so I will try and pull together a quick meal rather than having him eat junk. Then he seems to move on rather than getting caught up in the need to snack constantly. I worry about him developing type II diabetes and would hate for him to have the added stigma of obesity in addition to all his other problems BUT the improvement in his behavior is dramatic and allows him to get so much more out of life so we will try to keep the weight gain at bay and pray that risperdal continues to work.

 

[Robinboots]

Interesting. My J went into foster care (posted elsewhere), and in the space of a few months gained 50 pounds - no medications, either. He's been back home for 6 weeks and hasn't lost an ounce, but just started on Risperdal last night. Have to admit, I'm a little concerned, but at the same time it seems he actually DID take the pill last night: much calmer today, less sarcastic, bitter, angry, more even...I think in the short-term, at least, it will be worth it.