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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Collete on August 23, 2001, at 19:38:40
I would be so appreciative if some of the great minds here would suggest some meds for my relative who has had an eating disorder literally for her whole life. She has a limited number of foods she will eat and of course, they are all carbs. She will actually will gag on most vegetables or healthy foods. She is seeing a psychologist and will start with a pdoc soon. She suffers from depression which is like a soft bipolar and has terrible PMS as well. Prozac has been helpful for her, but it just isn't enough. She has a very hard time sticking to projects and completing things. I realize that her doctors will have ideas, but we all know that it is a good idea to be an informed patient. I was the one who brought up Zyprexa to MY pdoc and it may possible change my life! I think it would be great for her also, but the appetite stimulation is not something that she can overcome with her limited discipline. She is in her mid-30's and is very unhappy with her inability to overcome her food addiction. Any ideas? Thank you so much, Collette
Posted by Janelle on August 23, 2001, at 20:30:51
In reply to Best meds for eating disorder(obesity) and depress, posted by Collete on August 23, 2001, at 19:38:40
Hi there! Seems like I'm often one who answers your threads!
The Prozac sounds like a good start for your relative, and Zyprexa would definitely be a "no-no" since it causes weight gain in soooo many people.
If you feel that a med like Zyprexa would be appropriate for your relative, the one alternative I know of is Resperidol, which I learned on HERE was developed as a counter to Zyprexa with its appetite stimulation.
Also, for the soft Bipolar you mentioned, a mood stabilizer (I'm on Lamictal, but Depakote is another one) might be something for her to ask the pdoc about.
I bet there are meds specifically targeted toward addictions such as food (maybe some that are for OCD?), and hopefully others on here may know some names to give you.
Best wishes,
-Janelle
Posted by Zo on August 24, 2001, at 16:22:32
In reply to Best meds for eating disorder(obesity) and depress, posted by Collete on August 23, 2001, at 19:38:40
I'm wondering if Wellbutrin might help, since Zyban (same drug) helps with smoking. . .it is dopaminergic, which is what addicitons are all about.
Zo
Posted by jojo on August 25, 2001, at 10:33:12
In reply to Best meds for eating disorder(obesity) and depress, posted by Collete on August 23, 2001, at 19:38:40
> I would be so appreciative if some of the great minds here would suggest some meds for my relative who has had an eating disorder literally for her whole life. She has a limited number of foods she will eat and of course, they are all carbs. She will actually will gag on most vegetables or healthy foods. She is seeing a psychologist and will start with a pdoc soon. She suffers from depression which is like a soft bipolar and has terrible PMS as well. Prozac has been helpful for her, but it just isn't enough. She has a very hard time sticking to projects and completing things. I realize that her doctors will have ideas, but we all know that it is a good idea to be an informed patient. I was the one who brought up Zyprexa to MY pdoc and it may possible change my life! I think it would be great for her also, but the appetite stimulation is not something that she can overcome with her limited discipline. She is in her mid-30's and is very unhappy with her inability to overcome her food addiction. Any ideas? Thank you so much, Collette
Ritalin, Adderall, or Dexedrine, all appetite suppressives, appear to maintain their anorectic effects indefinitely when taken with SSRIs. Perhaps your relative could change the course of her life if her physician would deem this worthwhile and prescribe one of these stimulants for her.
jojo
Posted by jojo on August 25, 2001, at 10:41:38
In reply to Best meds for eating disorder(obesity) and depress, posted by Collete on August 23, 2001, at 19:38:40
> I would be so appreciative if some of the great minds here would suggest some meds for my relative who has had an eating disorder literally for her whole life. She has a limited number of foods she will eat and of course, they are all carbs. She will actually will gag on most vegetables or healthy foods. She is seeing a psychologist and will start with a pdoc soon. She suffers from depression which is like a soft bipolar and has terrible PMS as well. Prozac has been helpful for her, but it just isn't enough. She has a very hard time sticking to projects and completing things. I realize that her doctors will have ideas, but we all know that it is a good idea to be an informed patient. I was the one who brought up Zyprexa to MY pdoc and it may possible change my life! I think it would be great for her also, but the appetite stimulation is not something that she can overcome with her limited discipline. She is in her mid-30's and is very unhappy with her inability to overcome her food addiction. Any ideas? Thank you so much, Collette
As you mentioned soft bipolar symptoms, the addition of a stimulant might tend to increase the risk of a switch toward mania. This would be something that she would have to be cautious about, and be ready to discontinue the stimulant, and possibly the SSRI, if it should occur, and might even have to add an antimania drug if her physician thinks it advisable.
jojo
Posted by Jody on August 26, 2001, at 1:53:12
In reply to Re: Best meds for eating disorder(obesity) and depress » Collete, posted by jojo on August 25, 2001, at 10:41:38
Everyones' body chemistry is different, but generally speaking, Wellbutrin is an antidepressant that sometimes helps promote weight loss in some individuals. For the soft bipolar, topomax is a mood stabalizer that seems to help with weight loss in some people. (Just as an FYI - I gained weight on depakote and respiridal.) Hope that this helps.
Posted by Collete on August 26, 2001, at 8:11:57
In reply to Re: Best meds for eating disorder(obesity) and depress, posted by Jody on August 26, 2001, at 1:53:12
> Thank you all, I am learning a lot and Wellbutrin does seem to be a good place for her to start and probably not that "controversal" for her pdoc & ins. to allow also. She is currently on 20mg Prozac. I doubt that she could handle doing a "washout" so can she take Wellbutrin WITH Prozac?
Thanks again, Collette
Posted by jojo on August 26, 2001, at 14:40:22
In reply to Wellbutrin with Prozac?, posted by Collete on August 26, 2001, at 8:11:57
> > Thank you all, I am learning a lot and Wellbutrin does seem to be a good place for her to start and probably not that "controversal" for her pdoc & ins. to allow also. She is currently on 20mg Prozac. I doubt that she could handle doing a "washout" so can she take Wellbutrin WITH Prozac?
> Thanks again, Collette
I think it's pretty common to combine the two.
I did it for several years with no problems.jojo
Posted by SalArmy4me on August 28, 2001, at 0:21:01
In reply to Best meds for eating disorder(obesity) and depress, posted by Collete on August 23, 2001, at 19:38:40
"Preliminary studies suggest that Bupropion SR, approved for depression and smoking cessation, is an effective adjunct to diet for weight loss. We conducted a 6-month multi-center, randomized, double-blind, placebo-controlled, parallel-group study to test the safety and efficacy of Bupropion SR as an adjunct to a balanced energy-restricted diet and lifestyle program to treat obese adults. We enrolled 327 women and men, aged 18-65 years, with BMIs of 30-43. We excluded subjects who had a history of seizures, anorexia, bulimia, depression, psychosis, cigarette or substance abuse. After a 2-week run-in period subjects were randomly allocated to placebo, 300 mg/day, or 400 mg/day Bupropion SR. The lifestyle intervention included an energy-restricted diet (600 kcal deficit), use of 2 meal replacements/day, recording miles walked (pedometer), and a lifestyle diary. Subjects received dietetic counseling every 2-4 weeks. Retention rate at 24-weeks was ~70% and was similar in all groups. The weight loss (% of initial weight) and loss of >5% at 6 months (intention to treat analysis) are summarized in table.
Bupropion SR at 300 and 400 mg/day were associated with significantly more weight loss than placebo. This analysis suggests that the weight loss response to Bupropion SR is dose related. This study indicates that, in conjunction with a reduced-energy diet and exercise program, Bupropion SR can significantly enhance weight loss in a dose-related manner for obese subjects."
Posted by Jane D on August 28, 2001, at 12:25:08
In reply to Re: Best meds for eating disorder(obesity) and depress, posted by SalArmy4me on August 28, 2001, at 0:21:01
Sal,
When posting abstracts please include the citations so that we can find the study if we are interested.
Thanks,
Jane
Posted by SalArmy4me on August 28, 2001, at 14:01:26
In reply to Eating disorder - Again - please post cites. » SalArmy4me, posted by Jane D on August 28, 2001, at 12:25:08
That was from:
Diabetes
Volume 50 SUPPLEMENT June 2001 p A21
"Buproprion SR Significantly Enhances Weight Loss When Used with a Moderate-Intensity Lifestyle Intervention"
Posted by Jane D on August 28, 2001, at 15:23:16
In reply to Re: Eating disorder - Again - please post cites. » Jane D, posted by SalArmy4me on August 28, 2001, at 14:01:26
This is the end of the thread.
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