 bipolar disorder/PCOS
My 26 yr old daughter was officially diagnosed with PCOS earlier this year. She has been on various atypical anti-psychotics since age 15, when she was diagnosed with bipolar disorder. The PCOS is probably due to the extreme weight gain she's experienced from being on AP's. There is no family hx of PCOS and my once willowy daughter has paid a huge price for stability and functionality. She's currently on Abilify and Lamictal and has been working full time for 2 years and is engaged to a very special young man. Abilify has been a huge part of her stability and although it is supposedly weight neutral, it has contributed to even more weight gain plus the PCOS and associated CV risks.
She started seeing an endo last summer and he put her on the regular Metformin. She began at a low dose and increased it slowly. But she experienced severe nausea and extreme loss of appetite. The Metformin definitely helped regulate her menses, improve her bad acne, ease the ovarian pain and yes, lose some weight. But she was miserable with the Metformin side effects so her MD switched her to the extended release Metformin. That pretty much eliminated the nausea and vomiting but she felt like the XR was not as effective as the regular Metformin in controlling the PCOS sx. She gained 10 lbs in 3 months, her acne really worsened and she experienced more ovarian pain. Her endo totally dismissed this all and said that it was the same dose (duh---she knew that) and that both forms should do the same things. He said that the weight gain was "unacceptable" and referred her to a women's wellness center/dietician and reluctantly, agreed to let her go back to the regular Metformin.
Because of the bipolar disorder, she can not be on any form of hormonal birth control (Yaz.Yasmine both and not the spiro....? either). She tried an IUD for over a year and she had horribly, painful and heavy periods. She and her fiance use condoms and 2 yrs ago, she found herself pregnant. She terminated the pregnancy because of the bipolar disorder and the meds she was on. She and her fiance do not want to have children because of the health risk to her and the baby. He will have a vasectomy in the near future. Those couple months of being pregnant seemed to make everything worse so between the psych meds and the unplanned/terminated pregnancy, this led her where she is today.
She started the regular Metformin a week ago and has been dealing with major nausea and vomiting. She has decided to cut her dose in half and has been following many of the tips that women here have suggested. Ironically, she says that her skin is better already and her ovarian pain is less. I can see the difference in her complexion, too. She has an appt to meet with several specialists at the women's wellness center next week, who hopefully can help address the "catch 22" situation she's in.
My question is: has anyone else had a similar experience with the effectiveness of regular Metformin vs the XR form? I might add that she has always been VERY sensitive to med changes and doseage changes. She's a redhead and I swear she feels things that most other people would not.
Her wedding date is a year or so away and she understandably wants to look and feel better. Right now, she can't get excited about wedding plans because of her body issues. Her beloved Dad died suddenly and unexpectedly when she was 14. She's been to hell and back several times with the bipolar disorder and that she is alive today is somewhat of a miracle. She has wisdom and courage beyond her years and I am so proud of her perseverance.
Any comments, personal stories, advice, hope will be greatly appreciated. My daughter doesn't have a computer so I joined this group to see if we could find some support and help. Thanks for reading my lengthy first post! ~~N | 
