Family and Caregiver Schizophrenia Discussion Forum

My daughter has gotten HUGE from Risperadal - any alternatives?

What has been y’alls experience with your loved ones being on risperadal? did you find an alternative to it that worked just as well but without the weight gain? My daughter went from 110lb to 200lb in the past 2yrs and her being overweight is a constant source of her angry outbursts with me believing I am calling her fat behind her back. The doc has put her on appetite control meds but they do not seem to help. Thank you!


My son is on Invega now which I think is similar to Risperadal and I’m seeing his weight creep up.

Zyprexa did the same - took him from a near-starved looking 135/140 to about 200 in a few years.

In the middle of the switch, they tried him on some other new ones that they said didn’t have the same side effects - Vraylar, Latuda, Rexulti. Some didn’t work for his psychosis, others he wouldn’t even try.

This time, I’ve noticed my son will eat very healthy food if it’s available and enjoy it just as much, and sometimes more, than the junk food. So, I’m working on changing my own habits so that junk food becomes a rare thing, and we’re getting there.

For example, he’s taken a huge liking to salads, collard greens and beans lately. So, somehow, Hopping John came up in a discussion & he asked what it was, and luckily enough I had the stuff on hand to make it. Then he ate 2 big bowls of what amounted to some black-eye peas, tomatoes, onions, peppers and rice and was pretty satisfied. That’s a big improvement over eating a full bag of McDonalds, a whole pizza, or wanting me to make him an equivalent amount of chili dogs and cheese fries.

I think combined with exercise maybe we’ll get him to a place where he can be mentally and physically healthy.

Of course, it is easier to keep the weight off than lose it.

(When he had a problem last year about this time & stopped taking his zyprexa completely, he lost 60 pounds in 3 months - but I don’t recommend that as a diet option.)


Her father and i try to keep her fridge and cupboards stocked with healthy items but she just eats so much of it. Since she lives alone we buy her mostly frozen microwave Atkins meals, etc…since she cannot cook. I can rarely take her anywhere for activity because she is to unstable so therefore she just sits in her house all day. Guess I am hoping for a miracle pill! Do you live with your son?

We’re all hoping for a miracle pill. Right now, I’m hoping this Invega injection is a miracle. He’s only been on the Invega shot for going on 2 months, but I have high hopes for it. He still doesn’t want to go out too much though due to anxiety.

What about activity inside the house? We have a Total Gym that my son likes to use sometimes, and he probably paces enough inside the house & on the deck to make up a few miles a day.

My son does live with us. He first got seriously ill at 15 and now he’s 27. He’ll talk about being able to move out on his own sometime, because who doesn’t want to do that? Then, now & then, he’ll ask about when we’re buying another house, because that’s in the plans for several years down the road.

If she’s too unstable to go anywhere, are you guys talking about changing her meds?
And, I think someone here mentioned there is something they can give you to go along with some of the antipsychotics to stop some of the side effects? Is that what you’re talking about when you say appetite suppressant?

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I hate to admit it, but her dad (we are divorced) handles most of her meds because she is on his insurance plan and he is able to give them to her better than me. But, yes she was on some type of med to decrease her appetite ( I will have to get back with you on the name). Chelse has akathisia where she can’t sit still and paces alot too (like your son). The only reason she lives by herself is becasue she is to violent to live with me or her dad. We stop by throughout the day to check on her. She is in an inpatient psyche unit more than not and with this last discharge they have arranged to have homehealth come out a few tims a week. She has been on all types of meds but they keep going back to risperadal-even when we change docs those docs say risperadal is the best. She got a shot that was to be a trial shot for a 3-month shot (paliperidone? maybe?) Anyways it was to last 2 weeks in her system and then we would allow her to have the 3 month shot. Well she had a horrible psychotic episode because of that injection and so anyways, it has been a never ending battle for almost 3 years now. At least your son talks to you and sounds like he has hopes and dreams. My daughter just says all the time that she is dying, that the aliens have planted probes in her brain. Speaking of exercise my ex-husband and his wife did buy her a WI game but she has no interest in anything except listening to music with her headphones and laying on her bed.

Going to google Invega!

Well I feel stupid! Invega IS paliperidone! So that WAS the injection she had a month or so ago. Had a horrible adverse affect on her. Sounds like so far so good with your son being on it now!

I’m sorry Invega didn’t work for her - it’s been really good for a lot of people.

My son has only gotten violent with his father when he’s been very psychotic - he has a lot of paranoia wrapped up around his dad, and his dad’s presence even now ramps his anxiety up. Luckily, his dad is only home a night or two a week and he tries to be as quiet as possible now.

My son also has lots of days where he lays in bed with the headphones on and a blanket over his head. He says he’s enjoying his thoughts, but I know he’s lost in his delusions. He’s only been on the shot about 2 months. He’s way better than he was, but he’s still got a long way to go.

We’re going to try our hand at making homemade yogurt today, so it’s nice that he’s willing to do things like that now - and actually looking forward to it since he likes yogurt.

I had a thought, since you mentioned Atkins frozen meals. I am by no means a fanatic about my diet or healthy eating, but I have found that if I eat processed food, it puts me into a cycle of hunger and cravings. It takes about a week of feeling awful, but if I switch over to a diet with no sweets or soft drinks and nothing processed, my appetite switches off & I feel a lot better. It also means I pretty much just eat fruits, vegetables & meat with the occasional diet soda.

That would be too hard of a switch for her to make all at once, but if I’m eating bad, I feel better if I just add some kind of fresh fruits or vegetables to my diet. Since you guys are going there daily anyway, do you think she’d eat something like that if you brought it to her?

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My son has been on Risperadal for over a year. He has gain a lot of weight. He is now receiving SSI and FS, so I continue to buy him healthy food and some of the junk food he likes, but he just over eats. My son was very skinny until he started taking this medication, but I’m just glad he’s not delusional or paranoid and I don’t want his medication changed because it works well for him. I bought him a weight bench and he left weights, so hopefully that will help him. Hugs to you~


Metformin seems to be prescribed for metabolic side effects of APs. From wikipedia, “There is some evidence that metformin is associated with weight loss in obesity in the absence of diabetes.” Can also possibly prevent diabetes…

Many of the second generation APs change people’s metabolism with possible exceptions her doctors know about. [Side note: with your daughter’s psychosis never relenting, I wonder whether the doctors have tried clozapine. Clozapine has a potential serious side effect that has to be monitored with blood tests, but is said to work for treatment resistant psychosis.]

I kind of make hierarchies of difficulties to help me decide what to worry about. Being overweight is difficult, also stigmatized in our body-shaming society. A serious psychotic episode is horrible and can have negative consequences and attendant stigma far beyond weighing more than recommended BMI.

Hopefully your daughter’s meds and/or therapy/counseling can be worked out to where she can stabilize and make her own healthy choices to meet her own goals.

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Over the many years leading to my sons stability he has been on Geodon, Risperidol, Invega, Abilify, and numerous others that lead to him finally settling on clozapine…in that time he has gained 100 pounds…My experience is that the more that junk food, carbs and fats are regulated, not forbidden but just minimized and the more exercise is encouraged (in most cases you will have to exercise with them) the weight can be managed or at least the increases stopped. It takes time and there will be setbacks along the way…but in recent months my son has begun to lose weight and has so far lost almost 25 pounds…I have to walk almost every day for almost an hour with him each time…on a rare occasion he will do it by himself (and I get a break) and he may even go to the gym alone which is across the street from our house…he tends to follow my lead in most things and since I do almost all of the cooking for us…I have to make healthy meals but add something delicious or forbidden often enough to keep his interest. Once a month we have to go across town for haircuts and while there we stop into our favorite greek restaurant (King’s) where they serve these delicious monster gyros and this sublime home made cheesecake…throughout the month he is always asking for money for candy and treats and is only allowed a small amount for that which is quickly gone. I just keep reminding him about our upcoming trip to KIng’s and he seems okay with that. Keeping up water intake all day is critical too. Now if I can just lose some weight. lol PS> Food for thought: One of my son’s doctor’s years ago responded to my complaints about the massive weight gain in my son with this: “Do you want your son to be thin or sane?” Of course I want both but if made to select a choice of course I pick sane.


My daughter has tried most of the anti-psychotic meds out there and I think most of these medications cause weight gain and I wish it wasn’t so. Before her diagnosis my daughter was a double major in Dance and Spanish in one of the best state universities in my state. She had a beautiful, taut and muscular dancer’s body and now she weights over 300 lbs. It has been another strong reason she at times goes off her meds and who can blame her. Being overweight is not only unhealthy it’s also ostracizing. I pray one day there will be a medication that doesn’t cause all that weight gain. Your damned if you and damned if you don’t. A very difficult position to be in. Having said that I’ve known of folks who do maintain a good weight if they are extremely vigilant how much they eat and what it eaten. The medications cause tremendous food cravings.


Molly, They really do. My son said the medicine makes him hungry all the time and that his appetite is insatiable. What a shame that medicine cannot be fine tuned. He is wanting to get off again. He is back on his orthomolecular nutrients and I’m giving niacin to him on top of that but I think he is going to need the AP, maybe not as high a dose but some.


I was on risperdal consta had the same problem with the weight gain. I can tell you I was extremely hungry on it. I now take invega sustenna 78mg and I did have some weight gain but i kinda quit gaining weight on it after a while. I don’t eat as much as I was eating before and I am not as extremely hungry as I was before. I have also found some other people who have had the same thing happen on invega sustenna where they stopped gaining weight on it. All aps as far as I know are associated with weight gain but some you may not gain as much on. Results can certainly very from person to person as to how much weight they can on aps.

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sorry i just noticed invega didn’t work for her.

I also read that if these aps increase your appetite that you should try to eat low calorie foods

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Jassy22, I agree and always have fruits and salads available. We don’t buy empty nutrient foods and have changed to gluten free when available. It’s a journey and exercise is key also.

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One of the other benefits of niacin is that it controls the blood sugar. Get the book (Niacin the real story) and read up on it. Even if she doesn’t take it with the aim of beating her sz, her weight gain which of course is very bad for her heart and could bring on diabetes as well, may be controlled


On Geodon, my son was able to lose some of the weight he had gained while on Invega. When that stopped working well,he was on trials of other things and he gained weight again. He is now on Clozaril, and is losing weight again.

Yes - Metformin can be helpful for the increased risk of diabetes and also weight gain:

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