*snipped for focus
Mental health treatment teams
do work to mitigate the very common weight gain side effect as pointed out in my linked and quoted article.
Mental health treatment, unless court ordered, is voluntary so the visible side effects that can cause patients to be noticed and discriminated against are alleviated as much as possible to help with their medication compliance.
Cultural stigmas and negative perceptions about mental illness and the side effects of medications can discourage people from getting help which is a concern for the medical teams looking to help their patients.
No offence to those whose go to is Harvey Levin and Dr Drew but they are media personalities looking to yield attention from this tragedy by creating spectacles of themselves on the backs of the Reiner's tragedy when they have no verifiable information due to HIPPA nor confirmed knowledge of the Reiner’s long term situation, imo.
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Patients described that initially the extent and speed of weight gain was overshadowed by psychotic experiences and their treatment. This led to a shocking realization of weight gain.
The psychological impact of weight gain, most strikingly on the self‐concept, was profound. Loss of self‐worth and changed appearance amplified a sense of vulnerability. There were further consequences on mood, activity and psychotic experiences, such as voices commenting on appearance, that were additional obstacles in the challenging process of weight loss. Sedative effects of medication also contributed.
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The psychological journey of weight gain in psychosis - PMC
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The weight-gain that can result from treatment with antipsychotic medication may lead some individuals to discontinue medication, inhibiting their potential for improved mental health (Monteleone
et al. 2009).
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Switching antipsychotic medication is one method to reduce body weight, although this may not be clinically feasible. Switching from one drug to another is a clinical decision depending on several factors e.g. tolerance, safety and efficacy of molecules used. Such decisions are always to be taken in the best interest of the patient depending on the existent state of knowledge.
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If feasible, switching medication may be one solution. In many cases, weight loss (or weight control) programs will need to be incorporated into an individual holistic treatment plan.
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Weight-Gain in Psychiatric Treatment: Risks, Implications, and Strategies for Prevention and Management - PMC
all imo
Very interesting! Just some thoughts, on the weight gain issue. I’m familiar with meds that can cause weight gain, it’s a struggle for many people. All below, MOO
Ok, so add GLP-1, sounds good. ( if it can be tolerated, it has side effects too).
Remember Nick said he was on Wellbutrin in the Dopey podcast? Separate drug, but maybe same concern. Common SSRI anti depressants can cause weight gain.
Wellbutrin is an antidepressant ( different category), that does Not cause weight gain, so some patients request this med.
We don’t know why Nick was on Wellbutrin instead of a regular SSRI.
MOO, Wellbutrin is Not the most popular antidepressant, it is Not as effective for most people, much More suicidal ideation, than common SSRI type antidepressants.
Nick may have requested Wellbutrin, back then, 10+ years ago, to avoid weight gain( just a thought) so maybe a similar sentiment with his psych meds for Schizophrenia.
It seems, He preferred a med that did Not cause weight gain, even if Less effective. He did not anticipate a literal crisis this time, when switching meds!
Just an idea, that he has been concerned about keeping his boyish physique for some time.
Just guessing, I’m thinking Nick cared about his looks, saw his life slipping away due to mental illness and street drugs, no job, no partner. Then, because of Psych meds the last 5 years, he gained a lot of weight, lost his looks, in this short time. I’m guessing 60-75 pounds heavier, so 12-15 pounds a year, crept up. I can see this making him angry, resentful( of course, misplaced anger, always blamed others).
Perhaps, He took this mental “ wellness” reprieve for granted( “ok”, doing well, up to med change), he thought he could switch meds, be in the same “ good” condition mentally, just lose the weight.
My take, is that when Nick was changing meds( last month before crime), he was in close contact with his Psychiatrist. Then, during the transition, Nick “did not like the way he felt”, so he self medicated, reached out for street drugs, probably meth( linked with violence). Since he was in a vulnerable spot, anger, rage came out, led to acting out violently. MOO