Posted by bulldog2 on May 18, 2008, at 19:35:40
In reply to Re: How Docs Should Handle Med Weight Gain » bulldog2, posted by Racer on May 18, 2008, at 19:19:54
> That's one theory, and one possible mechanism for the weight gain from medications.
>
> It should be standard of care to check thyroid regularly for those with depression. In fact, I swear I read somewhere that it is part of the professional guidelines, but who knows if I'm remembering that right?
>
> Many medications cause weight gain in some people, but the mechanism of action may not be clearly understood. Depakote, for instance, is theorized to cause weight gain through the gastrointestinal irritation is can cause -- simple mechanism: it upsets the tummy, eating soothes it, so people eat more. That is about the only medication I've ever heard of which seems to cause weight gain through increased eating, and it can apparently be controlled with OTC acid-reducers. Others, like Zyprexa, cause weight gain through very different mechanisms, and will require different strategies for mitigation.
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> It's true that optimal thyroid function will help with weight control. But I'd hesitate to say that this is the way doctors should handle weight gain. I think thyroid function should be tested as part of normal treatment for depression, but I don't think that should be done as a target for medication related weight gain.Didn't imply that's the way doctors should routinely handle weight gain. Dietary habits should be the first thing that doctors look at. But thyroid testing should be done routinely. Actually a hormone panel wouldn't be a bad idea. Many of these meds (especially ones that elevate serotonin) will increase prolactin and if prolactin is not brought under control there will probably be weight gain. Another strategy might be to use prolactin lowering meds when prolactin is abnormally high.
I have a feeling to many docs are dispensing these meds without enough follow up blood work. At least that is the case with my doc.I have to request these tests.
poster:bulldog2
thread:829802
URL: http://www.dr-bob.org/babble/20080510/msgs/829861.html