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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by amyw on August 13, 2000, at 13:17:49
I had written about my 18 year old son who seems to have a problem that is unusual. His worst symptoms are a constant sensation like he has to eat and he has had many binges. He is the one I wrote about who was doing great on the wellbutrin and is even worse today. He says that maybe some of you are right and the only thing helping was the stimulant effect. He is feeling today as bad as he ever did and he is still on the 300 mgs of wellbutrin. He is in bed, toally devestated.
Anyway, has anyone ever had symptomns around cravings and urges to eat that are really intense. Has any medicine helped? I was wondering about the new mood stabilizers. One psychiatrist had thought he could be bipolar, but was a believer in risperdal as a mood stabilizer and it didn't work at all. Maybe something like lamictal??
I wonder if the wellbutrin just triggered a manic type episode and it actually wasn't the meds at all, but just the side effect of being activated. SEeing him like this is killing me and of course the doctor is away for two weeks.
There seems to be osmething wrong in his brain that stimulants type meds work only for a little while. IS there anything that keeps them working?
PLese help...
Posted by Tracy on August 13, 2000, at 19:35:10
In reply to binge eating disorder- anyone?, posted by amyw on August 13, 2000, at 13:17:49
I have been diagnosed with Binge eating disorder, as well as Depression. I was on celexa and wellbutrin, but was taken off, and put on effexor xr. One thought is that anxiety has a lot to do with the disorder -- and WB can cause anxiety; the celexa doubled part of what effexor was doing, so we also got rid of celexa.
Like any eating disorder, therapy is important. As far as I know, no one drug has been cited as the cure. It is a new disorder (as far as being diagnosed), and so there is very little out there about it. My pdoc is in the process of learning new therapy techniques to try to help me.
Interestingly, I had a wierd OCD behavior re: a certain way I read the newspaper when I was younger -- I had to read it in a certain way otherwise I would get major anxiety -- like I screwed up or something. Anyway, behaviors like these can show up later in life as eating disorders.
Might want to see a Pdoc specializing in eating disorders, if your not already.
Posted by Opolonio on August 14, 2000, at 1:28:00
In reply to binge eating disorder- anyone?, posted by amyw on August 13, 2000, at 13:17:49
> I had written about my 18 year old son who seems to have a problem that is unusual. His worst symptoms are a constant sensation like he has to eat and he has had many binges. He is the one I wrote about who was doing great on the wellbutrin and is even worse today. He says that maybe some of you are right and the only thing helping was the stimulant effect. He is feeling today as bad as he ever did and he is still on the 300 mgs of wellbutrin. He is in bed, toally devestated.
>
> Anyway, has anyone ever had symptomns around cravings and urges to eat that are really intense. Has any medicine helped? I was wondering about the new mood stabilizers. One psychiatrist had thought he could be bipolar, but was a believer in risperdal as a mood stabilizer and it didn't work at all. Maybe something like lamictal??
>
> I wonder if the wellbutrin just triggered a manic type episode and it actually wasn't the meds at all, but just the side effect of being activated. SEeing him like this is killing me and of course the doctor is away for two weeks.
>
> There seems to be osmething wrong in his brain that stimulants type meds work only for a little while. IS there anything that keeps them working?
>
> PLese help...I have had Binge Eating Disorder since long before it was recognized as valid eating disorder in DSM-IV. When I was taking lithium it stimulated my binge-eating so much that I gained 90 pounds in 2 years. After I was taken off the lithium I was put on Depakote, but, while it didn't stimulate my binge-eating, it was impossible to lose the weight that I had gained while I was on Lithium when I was taking it. I am taking Neurontin backed up with Lamictal, and the Lamictal is the first drug I've taken that has been able to help me stop binge-eating. I believe that if my psychiatrist were to raise my dosage enough to rid myself of the depressive symptoms which remain, I would possibly be able to finally bring my binge-eating under control.
Posted by Racer on August 15, 2000, at 14:34:10
In reply to binge eating disorder- anyone?, posted by amyw on August 13, 2000, at 13:17:49
How awful!
I've had an eating disorder for about 25 years now, though it's not always expressed. I also have trouble with anti-depressants. I'll babble for a sec, then you can decide if it's helpful or not.
First of all, the placebo effect works really well for a while. When I first start a drug that improves things at all, I feel on top of the world. Yippee, skippee, it's all gonna be over soon and I can get back to my life. Then, when the effects plateau, and it's clear that it's not the answer, I crash. It sounds as though something similar may be happening to your son.
One thing to consider: if the wellbutrin helped, maybe adding another drug to amplify the effects would help? That's what I'm on now: Effexor XR which has few side effects and releives the anxiety which is always part of depression for me, but doesn't quite do enough; combined with Prozac, since I'm sensitive to SSRIs, but get too many side effects from them. Works a treat, it does...
As for the eating, is he literally 'binge eating', or is he just eating a lot more because he feels overpoweringly hungry? Two different things, you know. If it's feelings of hunger, it could be a side effect of the drugs, or it could be a weird symptom of diabetes. One of the complications associated with diabetes is a sort of paralysis of the digestive system, which will screw up your sensations of hunger. It could also be a sign that the drugs are acting on a neurotransmitter associated with hunger (I think it's dopamine, but someone will correct me), and that a drug which effects other neurotransmitters will alleviate the symptom.
Good luck.
Posted by amyw on August 15, 2000, at 21:05:08
In reply to Re: binge eating disorder- amyw, posted by Racer on August 15, 2000, at 14:34:10
Racer,
His binge eating started after a bout he had with a kind of anorexia where he didn't like how he looked, but he only ate certain foods. He was 5'9 and 114 two years ago. Anywya, now he is over 149 which si not great, but better, bhis binge eating is like this: he feels a severe craving , almost a sensation in his mouth and an agitation that makes him feel like he has to eat. In any cacase, when he is alone, at times, he has consumed massive quantiites of food nad then hates himself and stays in bed for a day or two. THe only things hwich took away that craving sensation was adderall for five days and wellbutrin for 10 days. He also has more side efffects to SSRIs then benefit and now he is also feeling shitty on the wellbutrin. THe doc added prozac, but he never does well on htat.I can't actually say that other than the inital tremendous boost that you describe, only xanax as needed at least helps.
I keep thinking htat part of his symptopms are from his still low body weight, but that is another problem. THe wellbutrin made him lose 5 pounds.
Any ideas. I really appreciate your feedback
Posted by Racer on August 17, 2000, at 1:35:50
In reply to Re: binge eating disorder- amyw, posted by amyw on August 15, 2000, at 21:05:08
>
> Racer,
> His binge eating started after a bout he had with a kind of anorexia where he didn't like how he looked,
This doesn't surprise me. Good news/bad news time: The impaired self image involved in anorexia doesn't exactly go away. I still have trouble with it, though I've found that there's a 'critical mass' point I get to where everything seems to go away or come back (depending on whether I'm gaining or losing past it.) For me, the set point seems to be about 145 pounds, or about 10 pounds more than I'd like to be. Oh, well...One of the problems with anorexia treatments is that they don't really get to the root of the problem: they have to address the physical side first, then the mental or emotional side of it. That's all easy, since a starving brain can't function, and physical treatments alone won't fix the problem. Unfortunately, anorexia changes the way your brain and body work together to process food, hunger, appetite, and insulin. I can't tell you what it will take to fix the problem, because I still haven't found the answer. All I can say is that when my weight is up, I don't want to starve myself, and don't really overeat.
My depression effects my eating, though. First of all, when I'm depressed, I want to stop eating. It's partly punishment, since if I deserved to eat, I'd be better and not depressed. Partly, it's because I can't think clearly when I'm depressed, and I can't think clearly when I'm not eating. I do know that studies showed anorectics had a higher level of dopamine activity than normal, more like speed freaks than starving people. That's got to be involved in the process.
> I can't actually say that other than the inital tremendous boost that you describe, only xanax as needed at least helps.
Xanax, as an anti-anxiolitic, makes sense. There's a tremendous amount of anxiety to eating disorders. First, you don't want to eat, then you do eat, so you're a failure, so you don't deserve to eat more. Anything which reduces the anxiety will help with both sides of the eating problem.
Again, for me the Effexor was a miracle drug. While it didn't fix the depression, it did reduce my anxiety immediately, which started me eating again. (Some of the old-timers here may remember that I switched from Serzone to Effexor, the Serzone made me throw up anything I ate, so that exacerbated the eating disorder... Funny, huh?)
>
> I keep thinking htat part of his symptopms are from his still low body weight,Very likely. A starving brain can't function. It's not just his body weight, though: his body has to get back to a state of health, a state of adequate nutrition, before he can think well enough to recover his equalibrium.
but that is another problem. THe wellbutrin made him lose 5 pounds.Wellbutrin is supposed to be countermanded in the case of eating disorders because of the risk of seizures. Does his doctor realize he's suffering from eating disorders? Since anorexia is overwhelmingly a female disorder, the doctor may be missing the symptoms. Check into this one, since it's pretty serious.
What can you do for your son? Bad news, Mom, you can't do much. Love him, make good food available to him without pressuring him to eat, make it easier for him to get to appointments by offering him rides. If you can think of little things you can do for him, bringing home a magazine he might like from the store, cooking eggplant because he likes it even though you're not crazy about it. Stupid little things, but not too many of them. Remember: you can't make him recover. Right now, if he's experiencing anything like what I have gone through, he's feeling so wretched that he probably thinks he doesn't deserve any sort of kindness on your part. He's probably thinking that he's such a drag on you, such a problem for you, that he's torturing you by being alive. Making it easy for him to get to the doctor, helping him get through to his doctor that these drugs ain't doing the job, and helping to reduce pressure on him may help. Remember, though, that he probably feels guiilty and hopeless because you're reducing that pressure! Argh! What do you do??? Take a deep breath. Make yourself a cup of tea. You can't remmove all pressure from his life, but you can help him with the worst of it.
Also, look into some of the support groups and advocacy groups out there. There are organizations like the Depression Manic Depression Association, or the Manic Depressive Depressive Association, or others, that hold meetings where you can sit and listen and feel less alone. They do help, and I can't recommend enoug hthat you take him to one. If he won't go, or won't go again, try going a few times yourself. At least you can get some direct support and maybe some good ideas.
And get some support for yourself. You can't help him if you fall apart.
Take good care, Amy, and best luck to you and your son. He's lucky to have such a loving mother.
>
> Any ideas. I really appreciate your feedback
Posted by amyw on August 20, 2000, at 8:59:39
In reply to Re: binge eating disorder- amyw, posted by Racer on August 17, 2000, at 1:35:50
Thanks for your feedback.
Intermsof the wellbutrin, the risks are for bulikmia because ot hte change in electrolytes, but he doesn't throw up. ACtually the main psychiatrist fought against prescribing this because of the contraindications, but we got another doc to let him try it and it sitll has more effect on him than any other drub. Now the regular psychiatrist is writing for it too.
Posted by amyw on August 20, 2000, at 9:26:58
In reply to Re: binge eating disorder- amyw, posted by Racer on August 17, 2000, at 1:35:50
> >
> I got interrupted by my son and lost ny privacy. I also wanted to tell you atht the whole eating thing did start with a truama where he moved to another town, lost his friends, etc. However, the biochemitry on both sides is shit. I have been on prozac for 12 years and should have been on it when I was younger, but instead suffered through many wasted years of psychotherapy. I also have panic disorder . HIs dad has the same stuff.It is just hard to know if binge eating is a learned response. THere is no diabetes and nothing in his blood work. Somehow the stimulant action of wellbutrin seems to help.
Have you had any experience with being sick and finding that your meds temporarily don't work?
HIs weight is only 140 and probably should be 150, but he gets scared of overeating because of the binge thing.
It is so hard to be his parent sometimes, but I am super supportive. His step dad finds it a lot harder to understand and of course that puts me in the middle.
Thanks
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