The Last Psychiatrist: Why Zyprexa (And Other Atypical Antipsychotics) Make You Fat

October 19, 2010 1:59 AM | Posted by Anonymous: | Reply

Dopamine is a major metabolic controller. In animals dopamine along with melatonin is largely responsible for seasonal adaptation, i.e. hibernation. Human obesity is largely a hibernation response gone unchecked and chronically triggered by very high carbohyrate and abnormally decreased bright sun exposure combined with abnormal stressors (sleep deprivation and abnormal light exposure patterns - too much during sleep, not enough during wake).

In people taking zyprexa, blocking their dopamine receptors (and serotonin, and others) is making genes active that promote hibernation - they stop burning fat, stop storing fat, blood sugar increases, fertility shuts down, etc. It is no different than a hibernating animal.

In obese and diabetic humans it has been shown there is a paucity of dopaminergic signalling, and this is reversible upon glucose restriction. Downregulation of dopamine signalling is necessary to allow metabolic disorders to occur, why ? Because it is fundamentally a normal evolutionarily concerned hibernation tendency, it is only a disease in our modern society where tehse genes are being abnormally activated, chronically, year round.
Bromocriptine helps diabetes and obesity for this reason.

Regarding the observation that people on olanzapine are not using carbohydrate for energy, I would assume that is just the natural result of blocking multiple serotonin and dopamine receptors in the body - an inability, a debilitation, in using glucose for energy. This is a natural and evolutionarily conserved result of deficient neurotransmitter signaling, which again to the body signifies seasonal change and impending winter thus a hibernation-like response (metabolic conservation involving fat accrual, sleeping more, hunger, and shut down fertility).

It's been known for awhile that when the body switches to using fat for energy this will result in hyperglycemia and thus compensatory hyperinsulinemia, which leads to body fat gain. When the body insists on burning fat even in the presence of carbohydrate, it could mean any number of things... 1) pathological insulin resistance due to damaged /deficient mitochondria (glucose cannot get into the cells because the mitochondria are deficient, mitochondria therefore burn fat primariliy and glucose in the blood is elevated)... 2) someone is taking a drug that induces hibernation and transient metabolic conservation (with deficient dopamine and serotonin, the body refuses to accept glucose, uses fat instead as in hibernation, body fat and blood sugar increase as it might in early fall to prepare for winter. Fertility decreases in response to decreased dopamine and serotonin as well, and infertility is a major feature of winter adaptation/hibernation in animals as it is in humans on dopamine receptor blockers.)

Eating less carbohydrate, particularly sugar, is the obvious intervention to control obesity. Even though increased fat utilization occurs during metabolic disorder, it is ultimately the glucose portion of the diet that triggers the fat storage and diabetes... or at least the WORST of it. If the body wants to use fat, then feed it fat. If you try to feed it sugar, all that will happen is your pancreas will spew out insulin and your liver will convert it to fat which is efficiently stored in adipose. If you avoid eating glucose food, the worst of this hyperglycemic/hyperinsulinemic tendency is controlled.

Regarding getting the "truth" out there...It's well known receptor blockers for psych illness make you a hibernating animal that sleeps 14 hours a day and has no motivation and weighs 300 pounds. This is not breaking news. Perhaps it would eliminate the stigma against fat schizophrenics, but that's more about social status than science anyway... the poor, uneducated, mentally ill, overweight people, how unfortunate. NO one cares.

Maybe one day, in a land far away, we will treat schizophrenia and manic depression as biological illnesses and figure out what is causing them, and ultimately resolve them... rather than just shut the brain down with receptor blockers like a chemical lobotomy.

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via thelastpsychiatrist.com

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