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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 Racer on March 15, 2007, at 16:10:13
My shiny new pdoc is trying to address my anxiety by adding a serotinergic medication to my Old Faithful combo of Wellbutrin XL and Ritalin. So far, I can't say I'm impressed by the results, but I'm willing to continue the trials.
Right now, I've added Prozac, and am experiencing severely increased anxiety. Part of the anxiety is about weight gain, which has been an issue for me in the past. While I know he says he takes weight gain seriously, and I think maybe I might believe him, I'm still freaking out pretty severely. OCD type stuff, I know, but maybe a reality check from people who have experienced these things might help me.
So, my question: is weight gain from Prozac dose related? Would I be likely to gain less weight from 10mg than from 20mg? Or is it more generalized, with 10mg packing on as many pounds as any other dose?
I do trust him to start taking steps -- like Topomax, for example -- to limit weight gain. I just realized, though, that I don't trust him to start that until after I've gained a fair amount of weight. I know from the raw numbers that I am still a bit underweight, but I can't stand the thought of gaining any more weight. If he waits until I get into the high end of normal weight, I don't think I can stand it.
Thanks for anything anyone can offer.
Posted by TheMeanReds on March 15, 2007, at 17:07:48
In reply to Weight gain again..., posted by Racer on March 15, 2007, at 16:10:13
I'm going today to see if I can add topamax to curb my appetite. Im not 'fat' but my doc knows I can make my own vanity my main problem sometimes. Cross my fingers for you.
Posted by lymom3 on March 15, 2007, at 17:33:42
In reply to Re: Weight gain again..., posted by TheMeanReds on March 15, 2007, at 17:07:48
Topamax is not something to take lightly just so you don't gain a few pounds. It can pack some major whoop *ss side effects. I totally can relate to not wanting to gain any more weight but just be careful. I spent a solid 2 months with visits to my internal medicine doc, an endocrinologist, a cardiologist, ultrasounds, xrays, every blood test known to mankind and 2 trips to the ER only to find that there wasn't anything wrong with me. I stopped the Topamax (only on 100mg) and all my physical problems went away.
I realize that mileage varies for everyone and some do well on Topamax but to look at it as a "diet" drug is a serious underestimation. This is my opinion only and just from my personal experience.
Posted by Phillipa on March 15, 2007, at 21:27:29
In reply to Re: Weight gain again..., posted by lymom3 on March 15, 2007, at 17:33:42
Lymon what in the world did topamax do to you to cause all the tests in the hospital? And I never gained weight on any psych meds. Love Phillipa ps I excercise a lot I guess compared to others standards probably not to others standards. Just ride 7.5 or l4 miles on my bike each day. I dont think that's much as I used to run daily.
Posted by Sandra62 on March 16, 2007, at 8:01:50
In reply to Re: Weight gain again..., posted by lymom3 on March 15, 2007, at 17:33:42
I'm supposed to start Topamax on Tuesday. Could you elaborate on the side-effects? TIA!
Posted by lymom3 on March 16, 2007, at 10:42:36
In reply to Re: Weight gain again...for Lymom3, posted by Sandra62 on March 16, 2007, at 8:01:50
Like I said, this was just me and maybe not typical of everyone but that drug hits your temporal lobe hard. First, finding the correct dosage is huge. Too much or too little and you are worse off than if you took nothing. At 50mg I cried all day long. Bumped it up to 100mg and it was probably the most level headed I've been in my life.
Then my hair started falling out...in clumps. I had major gall bladder problems. Massive night sweats, insomnia and extremely tired and legarthic, chronic diarrhea and massive peripheral edema. The case of the stupids is fairly common...where you can't come up with words that you know or get your sentences jumbled. That's why they call it "dopamax" or "stupimax".
These bad side effects didn't start until about 6 weeks into taking Topamax so at first it didn't seem to be med related. So I had blood tests for diabetes, thyroid, electrolites, HIV, anything they could think of. I had ultrasounds of my whole abdomen, chest xrays, stress test. They could find nothing at all out of the ordinary.
At that point I talked to my pdoc and I weaned down and discontinued the Topamax and all symptoms went away. I had my mood problems back again and am now on Lamictal but all the other symptoms rectified themselves with the exception of the insomnia. I have just now found Seroquel that helps me sleep like a baby...I couldn't be more pleased with that.
Like I said, there are lots of people that do well on this medication and one horror story shouldn't deter you from trying it, but if you do get bizarre side effects that you might not normally attribute to meds, just keep track of them. The gall bladder pain that I had was unbearable. That got me to the ER once because I had never felt anything like that before. I never even dreamed that an anti seizure med could possibly be the culprit.
So, you know your body better than anyone; just note anything odd and make sure you talk to your pdoc about it..
Posted by yxibow on March 17, 2007, at 11:15:25
In reply to Re: Weight gain again...for Lymom3, posted by lymom3 on March 16, 2007, at 10:42:36
> Like I said, this was just me and maybe not typical of everyone but that drug hits your temporal lobe hard. First, finding the correct dosage is huge. Too much or too little and you are worse off than if you took nothing. At 50mg I cried all day long. Bumped it up to 100mg and it was probably the most level headed I've been in my life.
>
> Then my hair started falling out...in clumps. I had major gall bladder problems. Massive night sweats, insomnia and extremely tired and legarthic, chronic diarrhea and massive peripheral edema. The case of the stupids is fairly common...where you can't come up with words that you know or get your sentences jumbled. That's why they call it "dopamax" or "stupimax".
>
> These bad side effects didn't start until about 6 weeks into taking Topamax so at first it didn't seem to be med related. So I had blood tests for diabetes, thyroid, electrolites, HIV, anything they could think of. I had ultrasounds of my whole abdomen, chest xrays, stress test. They could find nothing at all out of the ordinary.
>
> At that point I talked to my pdoc and I weaned down and discontinued the Topamax and all symptoms went away. I had my mood problems back again and am now on Lamictal but all the other symptoms rectified themselves with the exception of the insomnia. I have just now found Seroquel that helps me sleep like a baby...I couldn't be more pleased with that.
>
> Like I said, there are lots of people that do well on this medication and one horror story shouldn't deter you from trying it, but if you do get bizarre side effects that you might not normally attribute to meds, just keep track of them. The gall bladder pain that I had was unbearable. That got me to the ER once because I had never felt anything like that before. I never even dreamed that an anti seizure med could possibly be the culprit.
>
> So, you know your body better than anyone; just note anything odd and make sure you talk to your pdoc about it..
I've never heard anything much about weight gain related to Prozac, its usually weight loss. But sounding like you have a fair amount of stimulants in your mix you might respond the other way.And yes, Topamax has definite issues with internal organs. Not something that should be messed with lightly. I'm glad you had all your tests with it, because I hate to say it, but I know someone who had their gall bladder removed. Now there is a genetic tendency there so its hard to say what the real root reason was but not something I would start up (again ?) -- I forget if I tried it now.
-- best wishes
Posted by Maxime on March 17, 2007, at 12:55:03
In reply to Weight gain again..., posted by Racer on March 15, 2007, at 16:10:13
Hi Racer
I was on 100 mg of Prozac for 3 years (it stopped working after 1 year, but I kept taking it because I wasn't able an MAOI until I lived in the US.). I didn't gain weight. I even went down to my low weight of 68 pounds.
How about L-tryptophan, a precusor to seretonin? I take one gram at night to help with sleep (I don't know if it does, but I know I don't get enough seretonin through my diet)
Prozac isn't known for causing weight, is it? Most people lose a few pounds.
Take care.
Maxime
> My shiny new pdoc is trying to address my anxiety by adding a serotinergic medication to my Old Faithful combo of Wellbutrin XL and Ritalin. So far, I can't say I'm impressed by the results, but I'm willing to continue the trials.
>
> Right now, I've added Prozac, and am experiencing severely increased anxiety. Part of the anxiety is about weight gain, which has been an issue for me in the past. While I know he says he takes weight gain seriously, and I think maybe I might believe him, I'm still freaking out pretty severely. OCD type stuff, I know, but maybe a reality check from people who have experienced these things might help me.
>
> So, my question: is weight gain from Prozac dose related? Would I be likely to gain less weight from 10mg than from 20mg? Or is it more generalized, with 10mg packing on as many pounds as any other dose?
>
> I do trust him to start taking steps -- like Topomax, for example -- to limit weight gain. I just realized, though, that I don't trust him to start that until after I've gained a fair amount of weight. I know from the raw numbers that I am still a bit underweight, but I can't stand the thought of gaining any more weight. If he waits until I get into the high end of normal weight, I don't think I can stand it.
>
> Thanks for anything anyone can offer.
Posted by Racer on March 18, 2007, at 2:12:14
In reply to Weight gain again..., posted by Racer on March 15, 2007, at 16:10:13
Thank you all for your responses. I do appreciate them.
My question, though, is whether the weight gain from Prozac is dose related? Does anyone know anything about this?
And to avoid any debate about whether or not Prozac causes weight gain, most newer studies show that it causes weight gain for some people, but not others; and that the weight gain usually starts after six to nine months on the drug.
Thanks!
Posted by madeline on March 19, 2007, at 13:29:36
In reply to Here's the question that got lost in this, posted by Racer on March 18, 2007, at 2:12:14
Racer,
This is the only thing I could find on PubMed about prozac and dose-dependent weight gain.
I also saw one entry on google when I searched on fluoxetine and "dose-dependent weight gain" that seemed to indicate that in patients with AN, there was a dose dependent weight gain in patients on fluoxetine therapy.
However neither I nor my instiution had a subscription to the journal, so I couldn't read (or post) the article.
From the little I know about prozac, however, I don't think much has been demonstrated about the dose-dependent effects of the drug on anything but seizure activity.
I guess my question would be do you think that Prozac therapy would help you tolerate weight gain if it occurred?
maddie
ps, i'll keep digging when I have time.
Posted by Racer on March 19, 2007, at 17:29:37
In reply to Re: Here's the question that got lost in this, posted by madeline on March 19, 2007, at 13:29:36
>
> I guess my question would be do you think that Prozac therapy would help you tolerate weight gain if it occurred?That's a fair question. My answer depends, though: my gut says, "no way no how no no no." And it stands by that ;-) Realistically? My experience has been that I get kinda fatalistic about weight gain when it happens, and it does consistently devastate my self-image and self-esteem. So, would it help me tolerate the weight gain? Probably to a small extent. It wouldn't be a "cure" for my reaction to weight gain, though.
That's based on my previous experiences with meds. They've all caused weight gain except Wellbutrin XL and Ritalin, which is the combination I was on before starting with this new pdoc. Effexor/Prozac, Paxil, nortriptyline -- those are the three I've been on for any length of time, and they've all caused significant weight gain. ("Significant" by any standards: between 45 and 70 pounds.) I ask myself if I wouldn't consider some weight gain to be worth it, if I were calm and not depressed. But the truth is, I don't know that I've ever gotten to that level of remission, and what I remember now about any of those combinations was sedation, chronic constipation, insomnia, weight gain, anorgasmia, and hating myself for being fat and lazy. That's probably not an entirely accurate view of how I felt, but that's what I remember. (Especially since the amotivation and sedation and apathy are side effects of the serotinergic drugs for me.) With that experience to look back on, I would rather stick to the Wellbutrin XL/Ritalin combo, even though it's not perfect and does nothing for my anxiety.
Anyway, that's a long way around saying, "That's a fair question, but I think the answer is 'no'."
>
> maddie
>
> ps, i'll keep digging when I have time.
>Thank you. I really appreciate you looking into it. I wouldn't have thought to look at medline, so I especially thank you for showing me another route to more information.
Posted by elanor roosevelt on March 19, 2007, at 22:33:53
In reply to Thank you! » madeline, posted by Racer on March 19, 2007, at 17:29:37
I have done quite a bit of reading on this topic. One meds I went from 120 to 180 in 3 years. It's not just changes in appetite. It's the metabolism shifT. It's almost impossible to lose the weight. and i work out like a mad woman. well, i am a madwoman and i work out to escape my demons which is not an easy task.
the only med-related weight loss i expereienced was on parnate. lost 10 pounds, had lovely cuticles and nails, didn't fidget. stared a lot. despised myself. but i looked good.
This is the end of the thread.
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