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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by shellie on October 27, 2000, at 22:06:55
Since my relapse into severe depression, the best combination for me has been nardil and lamictal. But as I was increasing the lamictal, my weight was going up. Also I had a lot of discomfort in my breasts. I did not experience an increase in appetite, so my eating didn't increase, and I was doing the treadmill.
I tried dieretics but it didn't seem to help. Yet within less than two weeks after stopping the lamictal I lost 9 pounds (not dieting or exercising).
My question is can you lose nine pounds in such a short time without it being water retention? The dieretic I took always works for me premenstrually, so I know it has been effective.
The reason I am asking this question, is that I am so tired of being depressed and wouldn't hesitate to go back on the lamictal if I didn't gain weight. But I was scared that I would get to be a huge person and I have enough problems with self-image not to deal with that.
Any ideas about the mechanisms of weight gain and such a fast loss? Shellie
Posted by SLS on October 27, 2000, at 23:41:24
In reply to Types of Weight Gain on Meds, Probably Revisited, posted by shellie on October 27, 2000, at 22:06:55
> Since my relapse into severe depression, the best combination for me has been nardil and lamictal. But as I was increasing the lamictal, my weight was going up. Also I had a lot of discomfort in my breasts. I did not experience an increase in appetite, so my eating didn't increase, and I was doing the treadmill.
>
> I tried dieretics but it didn't seem to help. Yet within less than two weeks after stopping the lamictal I lost 9 pounds (not dieting or exercising).
>
> My question is can you lose nine pounds in such a short time without it being water retention? The dieretic I took always works for me premenstrually, so I know it has been effective.
>
> The reason I am asking this question, is that I am so tired of being depressed and wouldn't hesitate to go back on the lamictal if I didn't gain weight. But I was scared that I would get to be a huge person and I have enough problems with self-image not to deal with that.
>
> Any ideas about the mechanisms of weight gain and such a fast loss? ShellieNo. Sorry.
I am becoming more interested in the mechanisms responsible for weight gain myself. I haven't taken the time to pursue it. I think Anita may have some understanding of it.
Tough decision, my friend.
I can identify with your dilemma. I am a former bodybuilder (former not by choice but by illness) who was muscular and lean with about 10 percent body fat. 9 lbs is better than the 40 lbs I gained on imipramine. I may have to go back on it. I think I can accept the trade-off, though, all things considered. Cost vs benefit vs need vs available alternatives. I had become accustomed to having members of the opposite sex whistle at me or pull a neck muscle. It's tough to watch that fade. But what the hell good is 10 percent body fat when you are house-bound and there is no one there to see you?
I don't know. It is so easy to say.
I have been on Lamictal a few times. I have been taking it steadily for about 3 years. After the initial weight-gain of 10 lbs, I have not gained any more.
Shellie, considering how Lamictal has contributed to your best response so far, I think I would sorta, kinda, maybe, tentatively, and sheepishly suggest that you may want to sorta, kinda, maybe, non-bindingly, give a sorta, kinda, semi-serious, consideration to the idea that perhaps it might be a sorta, kinda, revokably, and possibly reasonable decision to temporarily entertain the idea that it might be in your current best interests to try Lamictal again and perhaps remove it in the future should you find a better treatment that allows you to. In the meantime, perhaps someone will come up with an elegant and benign way to counteract the weight-gain.
Don't take my picture until I can bench-press 265 again. :-)
Sincerely,
Scott
Posted by stjames on October 28, 2000, at 3:17:00
In reply to Re: Types of Weight Gain on Meds, Probably Revisited, posted by SLS on October 27, 2000, at 23:41:24
James here.....Glead to have SLS looking into this issue ! I've done
a little research. With me the AD's make me crave foods, esp. carbs,
so I know where the weight came from. It is very clear they many just
gain without changing their diet. I know an anorexic that gains on AD's.
So clearly something else is effecting weight gain.
I suspect metabolisim is changed while on AD's. Insulin levels
may be changed also. Many report carb cravings. On thing to try
might be "the carbohydrate addicts diet". It is not a restrictive
diet at all, very healthy. More a new way to eat. The bood is written by a
MD and a psychologist, Drs. Richard & Rachael Heller. The webpage is:
http://www.carbohydrateaddicts.com/
Posted by shellie on October 28, 2000, at 12:14:28
In reply to Re: Types of Weight Gain on Meds, Probably Revisited, posted by stjames on October 28, 2000, at 3:17:00
Since my 10 added pounds were on top of twenty pounds I already needed to lose, I am not yet ready to accept a weight gain. I have looked into the low carbohydrate diets and don't really feel they are healthy, too little fruit and vegs. Also I am a vegetarian so its really hard to work those diets without meat or chicken. My therapist and pdoc say it is worth it to be a bit chunky, but having been thin all my life, I have not come to that conclusion. Yet, anyway. But thanks.
Posted by R.Anne on October 28, 2000, at 15:16:46
In reply to Types of Weight Gain on Meds, Probably Revisited, posted by shellie on October 27, 2000, at 22:06:55
Shelley,
I'm not familiar with the medicines that you are talking about but I recently went off of Risperdal and lost 7 pounds in 3 weeks. Mind you, I had been trying to lose weight while on the risperdal but found it almost impossible. I was able to cut my portion sizes and not feel hungry. I have also been taking Metabolite but it didn't really work until I stopped the risperdal. I, too, suffer from severe chronic depression and OCD. I'm taking effexor and paxil and now I find the effexor curbs my appetite-without the risperdal. I've had some sleep problems when I take the effexor too late in the day, though. So now I'm trying to take it earlier. I'm still having a hard time getting out of bed but at least I don't feel like I have nothing to live for today. I don't know if any of this has helped but I thought I'd tell you what's going on with me since we share this hellish depression. One more thing, the risperdal was helping with the depression and after I went off of it I took a dive again into the pits but when I increased the effexor xr to 3 (37.5 mg.)it helped the depression a lot. I have also recently increased the paxil to 30 mg. I went off of the risperdal because I believe it was playing havoc on my hormones, causing muscular problems, and weight gain. So, I relate to you on the weight gain, too, and don't want to gain any more.
****
> Since my relapse into severe depression, the best combination for me has been nardil and lamictal. But as I was increasing the lamictal, my weight was going up. Also I had a lot of discomfort in my breasts. I did not experience an increase in appetite, so my eating didn't increase, and I was doing the treadmill.
>
> I tried dieretics but it didn't seem to help. Yet within less than two weeks after stopping the lamictal I lost 9 pounds (not dieting or exercising).
>
> My question is can you lose nine pounds in such a short time without it being water retention? The dieretic I took always works for me premenstrually, so I know it has been effective.
>
> The reason I am asking this question, is that I am so tired of being depressed and wouldn't hesitate to go back on the lamictal if I didn't gain weight. But I was scared that I would get to be a huge person and I have enough problems with self-image not to deal with that.
>
> Any ideas about the mechanisms of weight gain and such a fast loss? Shellie
Posted by anita on October 29, 2000, at 18:48:09
In reply to Types of Weight Gain on Meds, Probably Revisited, posted by shellie on October 27, 2000, at 22:06:55
Hi Shellie,
Some hypothesize that H1 antagonism or 5HT2C antagonism can be involved in weight gain. However, these neurotransmitters aren't antagonized by Lamictal or nardil, as far as I know. They're mainly implicated in antipsychotic weight gain.
While I didn't seem to add any weight when I added Lamictal to nardil, I did lose a lot of weight very quickly when I went off nardil. Since I had edema on nardil, I too thought that maybe water retention had something to do with the weight gain. I used spironolactone, a diuretic, on and off for PMS, but it didn't affect my weight.
Some people lose weight on Topamax (200mg or more), a new mood stabilizer, and take it (experimentally) for weight gain with other meds.
anita
> Since my relapse into severe depression, the best combination for me has been nardil and lamictal. But as I was increasing the lamictal, my weight was going up. Also I had a lot of discomfort in my breasts. I did not experience an increase in appetite, so my eating didn't increase, and I was doing the treadmill.
>
> I tried dieretics but it didn't seem to help. Yet within less than two weeks after stopping the lamictal I lost 9 pounds (not dieting or exercising).
>
> My question is can you lose nine pounds in such a short time without it being water retention? The dieretic I took always works for me premenstrually, so I know it has been effective.
>
> The reason I am asking this question, is that I am so tired of being depressed and wouldn't hesitate to go back on the lamictal if I didn't gain weight. But I was scared that I would get to be a huge person and I have enough problems with self-image not to deal with that.
>
> Any ideas about the mechanisms of weight gain and such a fast loss? Shellie
Posted by shellie on October 29, 2000, at 23:25:52
In reply to Re: Types of Weight Gain on Meds, Probably Revisited » shellie, posted by anita on October 29, 2000, at 18:48:09
Thanks Anita, for the info.
Actually, it's so strange how individual reactions are to weight gain/loss. I never gained any weight on nardil (I was young and thin when I started, anyway) and I didn't lose any weight when I got off. Yet while on lamictal which is not particularly known for weight gain, (I think 17% gain on it)-- I gained and lost right away when I went off. I did try topomax for at least a month this past summer, hoping I'd get the same antidepressant effect as I had with lamictal. Unfortunately I slept at least sixteen hours a day on it, and it didn't seem to do anything for my depression. Very disappointing.It's strange, there's a thread about coming to terms with being on an antidepressant for life. I felt so grateful that something helped me, I've never cared about being on nardil. Now that nardil is no longer effective for me, I would be so relieved to find something or a combination that works. After not having to deal very much with depression (except premenstually) for years, it feels so awful to be back in the same scarey helpless position wondering if something will help me again. I have lots of business commitments due before Christmas and it's taking everything I've got to hang in there this time. I'm hoping nardil with serzone will work, or if not, next try will be nardil with pindolol. Then I'm completely stumped. Shellie
Posted by MarkinBoston on November 1, 2000, at 19:17:51
In reply to Types of Weight Gain on Meds, Probably Revisited, posted by shellie on October 27, 2000, at 22:06:55
You might ask your pdoc for some metabolic rate (thyroid, preferably T3 more than T4 enhancer) or stimulant/appetite reducer (Ritalin or amphetemine) for the mix. High cortisol levels, associated tightly with depression and stress cause fat storage among other undesireable things. There are a few anabolic steroids that are appropriate for women in that they have very little or no androgenic (masculinizing) effect and promote fat loss and bone/muscle gain. This whole class of drugs have been deamonized by the DEA, AMA, and FDA that MDs don't have much experience with them and few willing to script them. Though "evil", they are safe enough for use in livestock destined for the dinner table. Not many studies get funded either - these drugs have already been branded evil and there is no interest is scientific data to the contrary.
I too was unconcerned about a little weight gain in comparison to not functioning well at all. Then I started reading about all the long term consequences of and worsening synergy of high cortisol, adiposity, increased estrogen levels, and for men, decreased testosterone levels. They all reinforce each other. Also important is getting enough level 3 (slow-wave) sleep which promotes Human Growth Hormone levels and keeps you leaner, so sleep architecture disturbances as part of the disease or the drug matter too. Increasing age in men >25 correllates with growing cortisol and estrogen levels and decreasing HGH and testosterone levels. All this increases risk for hypertension, stroke, heart attack, diabetes, obesity, and celebacy.
So now weight gain is more important to me and plays a part in what to add in to a cocktail containing an antidepressant. I feel lucky when I find an AD that works at all. I am on a diuretic anti-hypertensive and monitor my blood pressure because anabolic steroids and metabolic rate enhancers both tend to raise blood pressure, and the steroid I'm on, testosterone causes some water retention too, which the diuretic controls.
Unfortunately, as a woman, there is little hope in getting a script for Primobolan or Winstrol and your best bet is getting a stimulant or thyroid adjunct to an antidepressant from your pdoc. A family doc will just recite the patter about counting calories and exercising more. Exercise is the more important of the two because dieting reduces metabolic rate and exercise helps increase it. I find it hard to exercise when depressed, personally. When the libido is low, so is the motivation! Secondly, during exercise, cortisol levels are increased. So, like social withdrawl, other stressful (cortisol increasing) activities are naturally avoided by those with already high cortisol levels (many depressives).
Posted by shellie on November 1, 2000, at 23:18:19
In reply to Re: Types of Weight Gain on Meds, Probably Revisited, posted by MarkinBoston on November 1, 2000, at 19:17:51
Thanks Mark, for your suggestions. Unfortunately I don't do well on stimulents. I am already taking a natural thyroid t3 & t4 combination, but I might ask my doctor what she thinks about increasing it. I had started taking it on the advise of a doctor who had suggested that I take my temperature every morning and if it was very low, he'd put me on thyroid. I haven't really done the temperature test again to see if it's still very low. I think I'll do that, as soon as I remember to buy a thermometer.
This is the end of the thread.
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