Sunday, 6 April 2014
Anti-Psychotics and Appetite
I wrote a few posts ago that I was relapsing into an eating disorder. I've realised now that that wasn't quite true. Since I stopped quetiapine it's become clear that the drug was mostly to blame. I may have been engaging in eating disorder "behaviours" but it wasn't really a psychological problem or any kind of "coping mechanism".
I actually took some quetiapine one day last week. It was very noticeable, having been off it for a while, how my mind started to fill with thoughts of food as it kicked in. I knew I wasn't physically hungry, but I felt a compelling need to be fuller, I was craving carbohydrates and I couldn't stop thinking about it. The next day I ate more than I had been previously too.
So I'd been over-eating while I'd been on quetiapine, and I'd been putting on weight (plus the medication must also alter metabolism somehow since the vast majority of the weight has gone on round my middle - and then of course there's the sedation, which was making me move less and more slowly.) This led to attempts to control my eating, to restrict myself, to fight myself, which led to failure, and then bingeing and purging. I'm just no good at dieting, it always derails me. The only way I can eat is to eat what I want, when I want it, and as much as I want. That is how I am eating again now, and I am losing weight, despite eating cake and chocolate and cheesy garlic bread. I know that eventually my weight will again stablise in the range that is normal for my body.
I suspect that many people who haven't experienced taking an anti-psychotic would suggest it is simply a matter of will-power. But that's rubbish. Now that I am not taking quetiapine any more, but aripiprazole, which is supposed to be weight-neutral, I don't think about food except when I am hungry, and when I feel as though I've had enough, I simply stop.