One would try to achieve the desired results with either no side effects or side effects the person can live with. I was on 500 bid and now my doctor wants to change me to topomax and rispordal to help me lose weight. Of the anti-psychotics that are known as atypical rispordal causes the least weight gain. Topomax, in many instances, actually causes weight loss. There are a number of papers and presentations concerning the use of topomax in bipolar affective disorder, and in many cases the results have been promising.
Weight gain is a real problem for most psychiatric patients.
With rare exceptions, the medications that we use can cause a significant increase in weight. For example, about half of the patients who take depakote will gain weight. All too often we are able to control the psychiatric symptoms only to have to deal with the body image problem due to weight gain and the very real medical complications that being significantly overweight can cause. My boyfriend's father is manic-depressive. It is clear that there is a genetic component to manic-depressive disorder.