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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 31. This is the beginning of the thread.
Posted by UgottaHaveHope on April 24, 2007, at 10:48:07
Reading about the dramatic weight gain of others on Nardil probably delayed me trying the drug for at least two months, maybe more. It wasn't until I was able to talk to some of you in here who experienced it for more details, along with some doctors, until I decided to proceed a trial of Nardil.
This is my third week, and I have dropped from 237 lbs. to 225. I am still doing the same exercise (30 minutes on cardio bike), just changed my eating habits. Start off every day with fruit, then eat salad or oatmeal for lunch, and pretty eating whatever I want for dinner, just in small portions like Weight Watchers.
I would NOT let the FEAR of weight GAIN stop you from TRYING Nardil.
I think ppl gain weight because of three reasons:
1. Nardil can boost your mood, and when you feel better you are likely to eat more and be merry.
2. Nardil can give you daytime sedation, which may make you less likely to exercise, which may cause you to gain weight.
3. Probably with 5 percent or less of the population, you will gain weight on Nardil, just as you will gain weight on an AP. But I would think this is the rare exception, not the rule. Besides, focus on feeling better first, then you can worry about weight by taking an amphetimine, etc. or something else.Bottom line of this post: Do NOT fear Nardil
Posted by gardenergirl on April 24, 2007, at 11:59:41
In reply to Nardil weight gain: Fact or Urban Legend?, posted by UgottaHaveHope on April 24, 2007, at 10:48:07
Weight gain and increased appetite are listed as documented adverse effects for nardil. It's not an urban legend, but like any adverse effect listed for meds, some will experience it, others will not.
Deciding to start any psychotropic medication requires weighing the potential benefits against known or potential risks. I think that's going to be different for everybody as well.
It's great that you're doing well, and I'm glad you posted your positive experience to date. Knowing that there are successes is good data for anyone considering a med. And you can't discount the power of hope. :)
gg
Posted by Quintal on April 24, 2007, at 12:37:23
In reply to Nardil weight gain: Fact or Urban Legend?, posted by UgottaHaveHope on April 24, 2007, at 10:48:07
I did a very similar thing to you when trying Zyprexa because I anticipated a lot of weight gain, so I ate mostly fresh fruit and veg and drank lots of water. I also took glucophage and by the end of the first month I weighed 2lb less than I did at the beginning. So weight gain need never be a certain outcome of any med, even with notorious plumping agents like Zyprexa.
Q
Posted by Racer on April 24, 2007, at 15:12:47
In reply to Nardil weight gain: Fact or Urban Legend?, posted by UgottaHaveHope on April 24, 2007, at 10:48:07
Actually, while your three examples may be part of the problem for some people, these medications do cause weight gain for many people, and it's not through behavioral changes.
For one thing, many of these drugs will hit receptors which control feeding behaviors. The combined effects on those receptors diminish the signals sent from your stomach to your brain telling you you're full. They also diminish bowel motility, and slow your metabolic rate. They do a lot to influence weight.
I'm glad that you've found something which is working for you, and I hope that others will try it, too, to see if it helps them as well. Thank you for posting it, both because of your good ideas, and for the hope it may give others. I'm only trying to show that those who HAVE gained weight from this or other meds are not to blame for it. It's not just a question of gaining weight because you're eating more or exercising less. Even some doctors will say that, and it's just plain wrong -- it's blaming the patient, and doesn't do anyone any good.
Sorry -- it's one of my soapboxes...
Posted by UgottaHaveHope on April 24, 2007, at 15:31:58
In reply to Re: Nardil weight gain: Fact or Urban Legend? » UgottaHaveHope, posted by Racer on April 24, 2007, at 15:12:47
Racer, I understand where you and GG are coming from and I appreciate you expressing the other side of the issue.
While you are saying "I'm only trying to show that those who HAVE gained weight from this or other meds are not to blame for it."
I am saying "Do NOT fear trying Nardil because of weight gain, which may or may NOT happen. It hasn't happened with me nor many others."
And again, the fear of the notorious weight gain on Nardil, which I think is realistic but overrated, delayed me from trying it for months. Like with any drug, not only Nardil, I would hate for someone not to try it because of a side effect that only some people experience. That fear could stand in the way of you trying a drug which could change your life forever (and has for many).
BOTTOM LINE, which has been repeated a million times on this site: EVERY med affects everyone DIFFERENTLY.
Posted by FredPotter on April 24, 2007, at 17:11:20
In reply to I understand where you are coming from but ... » Racer, posted by UgottaHaveHope on April 24, 2007, at 15:31:58
But how can fear of weight gain equate with the frantic dreadfulness of depression. Carefully weigh up whether it's worth the weight gain? I don't understand. With serious depression you will try anything to relieve the agony.
I'm eating less on Nardil but am putting on weight. I don't care. My sexual organs have shrivelled up into a useless piece of stuff involved with urination. I don't mind this so long as Nardil takes away the agony.
I understand for young people this is much more serious especially if you're trying to start a family, but then I'm hoping it'll go away anyway. Anyone tried periactin for this s/e?
Fred
Posted by Racer on April 24, 2007, at 19:17:18
In reply to Re: I understand where you are coming from but ... » UgottaHaveHope, posted by FredPotter on April 24, 2007, at 17:11:20
> But how can fear of weight gain equate with the frantic dreadfulness of depression. Carefully weigh up whether it's worth the weight gain? I don't understand. With serious depression you will try anything to relieve the agony.
>See, that's another difference. I'd say it's related to my eating disorder, and it may be in part, but I get to a place in depression where I say that the drugs are worse than the depression, so there's no point in trying anything anyway. It's part of that hopelessness of depression, for me.
And weight gain is a big part of it for me, when I get that way. There are other side effects that drive me nuts, but weight gain is right up there.
Good luck.
Posted by Phillipa on April 24, 2007, at 21:14:26
In reply to Re: I understand where you are coming from but ... » FredPotter, posted by Racer on April 24, 2007, at 19:17:18
I may not have an eating disorder but I at my age am not about to gain more weight. I have gained l5 pounds this winter and I will lose it with excercise and healthy eating. Love Phillipa. Health risks of wt gain are very real.
Posted by UgottaHaveHope on April 25, 2007, at 0:38:27
In reply to Re: I understand where you are coming from but ..., posted by Phillipa on April 24, 2007, at 21:14:26
Health risks of wt gain are very real for a LOT of MEDS, not just Nardil.
Sometimes I wonder if this is an encouraging board or discouraging board. It's like there will be 98 things that are fine with a drug, but ppl find the two POSSIBLE negatives to dwell on.
Not picking on you, Jan, but the affirmation of POSSIBLE side effects by ppl in here just scare people away from trying something that might help them. For example, it scared me and delayed me from trying Nardil until now. Until I saw through it all.
Posted by UgottaHaveHope on April 25, 2007, at 0:47:39
In reply to Re: I understand where you are coming from but ..., posted by Phillipa on April 24, 2007, at 21:14:26
Thats just a fact of life. I know plenty of ppl, especially in my family, who struggle with weight issues and have NEVER EVER NEVER been on any form of anxiety, depression or emotional-treating medicine.
Unfortunately, thats part of life, due to many reasons: metabolism, lack of exercise or diet, genetics, diseases, digestion problems, etc.
I think some (but not ALL, so please dont misread this). I think some but not ALL people will easily blame a drug for causing weight gain, then they go off on a tangent about it on this board, which in turn scares others from trying that same drug.
The chemical makeups of our all our bodies are all different. I appreciate everyone for sharing their experiences and my heart goes out to those who gain weight (on meds and not on meds) and struggle to lose it.
Posted by Jedi on April 25, 2007, at 2:38:22
In reply to Some ppl NOT on any DRUGS prone to GAIN weight, posted by UgottaHaveHope on April 25, 2007, at 0:47:39
Hi,
I'm one of those that Nardil reacts with something in my brain to shut off the response to being full. The cravings for sweet carbohydrates would be unbelievable to someone that has not experienced it. I'm not talking small stuff here, 110 Lb. gain at one point. I have lost weight on Nardil but it required two hours of intense exercise every day to do it. The weight gain was behind my recent switch to Parnate. The cravings shut off after a couple of weeks and I've lost about 20 Lbs in the last 7 weeks.Hard to believe that they sometimes use Nardil to treat bulimia. My guess is that people don't purge because the Nardil makes it so they don't care if they overeat. I'm sure that the bulimics will correct me on this, since it is just a guess.
No matter, there is nothing worse than severe treatment resistant depression. If the Parnate trial fails, I will be right back on Nardil. I have the stash saved up to do it. I don't like being obese and the associated negative health effects, but the depression is worse.
IMHO Nardil + clonazepam is the gold standard for treatment resistant atypical depression with social anxiety. Ironically, some of the symptoms of this disease are weight gain, oversleeping and leaden paralysis which are the same as some of the side effects of Nardil.
With that said, I will repeat a fact that I've stated several times here. Without Nardil, I would not be here today. I would have been taking the long dirt nap long ago. When the med first kicked in about ten years ago it was like magic. I went from being totally without hope to seeing the light in just a couple of days. I have been on probably 40+ combinations of meds now and nothing has worked like that.
Good Luck to All,
Jedi
Posted by UgottaHaveHope on April 25, 2007, at 3:04:13
In reply to Nardil + weight, posted by Jedi on April 25, 2007, at 2:38:22
It will help others.
Posted by jealibeanz on April 26, 2007, at 18:27:59
In reply to Re: Nardil weight gain: Fact or Urban Legend? » UgottaHaveHope, posted by Racer on April 24, 2007, at 15:12:47
> Actually, while your three examples may be part of the problem for some people, these medications do cause weight gain for many people, and it's not through behavioral changes.
>
> For one thing, many of these drugs will hit receptors which control feeding behaviors. The combined effects on those receptors diminish the signals sent from your stomach to your brain telling you you're full. They also diminish bowel motility, and slow your metabolic rate. They do a lot to influence weight.
>
> I'm glad that you've found something which is working for you, and I hope that others will try it, too, to see if it helps them as well. Thank you for posting it, both because of your good ideas, and for the hope it may give others. I'm only trying to show that those who HAVE gained weight from this or other meds are not to blame for it. It's not just a question of gaining weight because you're eating more or exercising less. Even some doctors will say that, and it's just plain wrong -- it's blaming the patient, and doesn't do anyone any good.
>
> Sorry -- it's one of my soapboxes...
Yes, I have to agree with you on this matter. As I've stated before, I gained tons of weight on AD's even while a competitive athlete in college training twice a day. It had nothing to do with my behaviors.I'm lucky enough that my doctors don't ever tell me I'm to blame and that I must be overeating and under-exercising, because they know that could not be true considering my activities. They'd just say that it's uncommon for someone with my activity level to rapidly gain on Effexor... and extremely uncommon with Wellbutrin. Yet, the correlation was there. This, along with apathy and other side effects, is why choose not to take AD's. If serontonin levels are increased even slightly with me I tend to feel off and have side efects.
However, I don't think someone should avoid medications because of others' experiences. You may be missing an enormous opportunity for improvement. Nardil is supposed to be rather robust and beneficial for anxiety and depression. It's worth a shot, IMO.
Posted by UgottaHaveHope on April 26, 2007, at 18:49:45
In reply to Re: Nardil weight gain: Fact or Urban Legend? » Racer, posted by jealibeanz on April 26, 2007, at 18:27:59
You've heard about the so-called "carb cravings" on Nardil? (I just drink water to resist it, at least so far). Well, nothing made me starve like Paxil. It made me want to eat kitchen appliances.
That is the No. 1 med I would FEAR if I was concerned about GAINING weight.
Posted by Quintal on April 26, 2007, at 18:52:23
In reply to Re: Nardil weight gain: Fact or Urban Legend? » Racer, posted by jealibeanz on April 26, 2007, at 18:27:59
I'd like to clarify that my post wasn't intended to imply people are to blame for the weight they gain while taking medication - it happened to me too over a period of time with different drugs. I was hoping my experience with Zyprexa might encourage people who are afraid of Nardil weight gain to give it a try, given that those measures were successful for me at least with another med notorious for causing weight gain.
Q
Posted by FredPotter on April 26, 2007, at 19:17:24
In reply to Fear gaining weight on PAXIL, not NARDIL, posted by UgottaHaveHope on April 26, 2007, at 18:49:45
Now come off it Michael. How much carbohydrate is there in a tin opener? And I hope you didn't try eating the blender without first switching it off. But I find I don't eat anymore that before, maybe less, but still put on weight. And I don't know what carb cravings are. But hey I'm supposed to be diabetic but Nardil has brought my blood sugars down to normal!
Fred
Posted by UgottaHaveHope on April 26, 2007, at 23:36:23
In reply to Re: Fear gaining weight on PAXIL, not NARDIL » UgottaHaveHope, posted by FredPotter on April 26, 2007, at 19:17:24
Yeah man, I was eating frozen food without even opening up the packages. Especially Swedish Meatballs, my favorites, which I cant eat anymore on Nardil :(
Posted by Racer on April 27, 2007, at 19:37:50
In reply to Fear gaining weight on PAXIL, not NARDIL, posted by UgottaHaveHope on April 26, 2007, at 18:49:45
When I posted, I was trying to be very specific: I was saying that, while the three behavioral patterns you mentioned in your first post may be involved for some people who gained weight on Nardil -- and I presume other ADs as well -- they were not the sole contributors of weight gain.
These drugs -- anti-depressants of all classes, anti-psychotics, anxiolytics, etc -- cause chemical changes which lead to weight gain for many people. Not everyone who gains weight on any of these medications does so because of behavioral changes.
That is what I was saying. I'm sorry if you didn't get that the first time. I tried to be clear.
Posted by Phillipa on April 27, 2007, at 19:42:17
In reply to Trying again to clarify what I said » UgottaHaveHope, posted by Racer on April 27, 2007, at 19:37:50
guess I'm lucky as I don't gain weight on the meds. Neither benzos, SSRI's or SSNRI's. Funny how we are all different. Love Phillipa
Posted by UgottaHaveHope on April 28, 2007, at 0:26:41
In reply to Trying again to clarify what I said » UgottaHaveHope, posted by Racer on April 27, 2007, at 19:37:50
Posted by jealibeanz on April 28, 2007, at 6:31:40
In reply to Re: Trying again to clarify what I said » Racer, posted by Phillipa on April 27, 2007, at 19:42:17
From what I've read, people who gain weight or have odd systemic side effects don't absorb the drug well through the blood brain barrier, so much of it stays in the rest of the body.
One company is working a drug that helps to lessen this problem. It's not really an AD by itself, although it may do some good, it's basically designed to make CNS drugs more effective. Actually it's a highly pure lipid, which is what cell membranes are partially composed of, and lipids go through cells easily, so this may help the drugs.
Sorry, tangent there...
Posted by Phillipa on April 28, 2007, at 18:49:30
In reply to Re: Trying again to clarify what I said » Phillipa, posted by jealibeanz on April 28, 2007, at 6:31:40
My turn to clarify Jelly. So you're saying if you do not gain weight you are getting more of the drug to your brain? Is this correct? As that would explain some of the strong side effects I've gotten in the past from ad's . Please clarify would explain a lot. whey the pdoc start me on very low doses for one thing. thanks Jelly
Posted by jealibeanz on April 28, 2007, at 19:19:52
In reply to Re: Trying again to clarify what I said » jealibeanz, posted by Phillipa on April 28, 2007, at 18:49:30
> My turn to clarify Jelly. So you're saying if you do not gain weight you are getting more of the drug to your brain? Is this correct? As that would explain some of the strong side effects I've gotten in the past from ad's . Please clarify would explain a lot. whey the pdoc start me on very low doses for one thing. thanks Jelly
>
I have no idea. I don't think any of the researchers do. It's just a theory that some are able to allow more medication into the brain that others. They're trying to come up with a way to fix this theoretic problem.Remember the little disclaimer in the prescribing info for all the psych drugs? The mechanism of all of the drugs is unknown. They have suspicions, but no concrete evidence.
So, no, I don't have an answer to your question. Medicine isn't quite that advanced yet, but is getting there.
I don't know why you start on low doses. Most doctors like to do that with patients to avoid any major complications or adverse effects. Plus, titrating up allows one to find the therapeutic level, without going over, which may cause side effects. That just the basic guideline for practice. I don't have any insight in terms of your treatment in particular.
Posted by Phillipa on April 28, 2007, at 20:01:54
In reply to Re: Trying again to clarify what I said, posted by jealibeanz on April 28, 2007, at 19:19:52
Jelly it wasn't just for me. I know you are very young. But part of my fear of meds is that in the past they the pdocs used to start at standard doses even mine has changed. An example would be in the past 50mg luvox first night and if toleratred 50mg both in the morning and at night second day. Now mine says 25mg and take for week first. Another is prozac used to only come in 20mg capsules now they can start as low as you like with liquid or small pills. This makes so much sense don't you think? I do that's for sure. Thanks I appreciated that. Love Phillipa
Posted by jealibeanz on April 28, 2007, at 20:29:10
In reply to Re: Trying again to clarify what I said » jealibeanz, posted by Phillipa on April 28, 2007, at 20:01:54
> Jelly it wasn't just for me. I know you are very young. But part of my fear of meds is that in the past they the pdocs used to start at standard doses even mine has changed. An example would be in the past 50mg luvox first night and if toleratred 50mg both in the morning and at night second day. Now mine says 25mg and take for week first. Another is prozac used to only come in 20mg capsules now they can start as low as you like with liquid or small pills. This makes so much sense don't you think? I do that's for sure. Thanks I appreciated that. Love Phillipa
My assumption is that standards of practice changed based on experience... most likely for the better. It's safer to start on a low dose.I personally can't imagine being bombarded with an SSRI like that. I think I'd be extremely uncomfortable. Even the standard slow titration does feel a bit odd.
Wow... I didn't know that's the way they were once prescribed, which wasn't all that long ago. I think patients must have been much more accepting of doctor's treatments and didn't question thing. People have a pretty low threshold for side effects and sub-optimal treatment. We just go in and demand something be changed. Doctors are no longer regarded as all-knowing beings.
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