Psycho-Babble Medication Thread 1110567

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Any solutions for Nardil weight gain?

Posted by SLS on June 8, 2020, at 8:52:05

I've seen some encouraging comments regarding the use of metformin to mitigate weight gain with Nardil.

Any other suggestions?

Is the weight gain with Nardil the result of increased appetite / caloric intake, metabolic changes, or both?

I've gained over 10 pounds in less than two months, and I don't see this process halting.

There's gotta be something I can do.

The weight gain is unwelcome, but an easy trade to make for remission from bipolar depression.

What do you guys think?

Thanks.


- Scott

 

Re: Any solutions for Nardil weight gain?

Posted by Lamdage22 on June 8, 2020, at 9:06:44

In reply to Any solutions for Nardil weight gain?, posted by SLS on June 8, 2020, at 8:52:05

Hey Scott,
thanks for posting. I was wondering wether you are still well. Awesome. I think there is no harm in trying. When I began taking it, I was on a low dose of Neuroleptics. Over night I ate less than half the calories compared with before. With ease. Kidney checks are something youd have to put up with though.

Now on this hefty AP dose I am slightly overweight, but I am losing weight right now. Ill be at my target weight soon.

 

Re: Any solutions for Nardil weight gain? SLS

Posted by undopaminergic on June 8, 2020, at 9:18:35

In reply to Any solutions for Nardil weight gain?, posted by SLS on June 8, 2020, at 8:52:05

> I've seen some encouraging comments regarding the use of metformin to mitigate weight gain with Nardil.
>
> Any other suggestions?

Stimulants are a classic.

> Is the weight gain with Nardil the result of increased appetite / caloric intake, metabolic changes, or both?
>

I think it starts with just the appetite, but as you continuously pathologically over-eat, you develop metabolic disorders such as high cholesterol and diabetes.

> There's gotta be something I can do.

Exercise will-power. That is not so helpful, I know, but one trick I've been using with success is to "fail" to buy sweets (candy; and the equivalent) and always abstain from eating when you are *not* craving -- this may mean skipping a regularly scheduled meal.

As for healthy eating, I'm no expert, but there is no shortage of information about that on the Internet and in books.

-undopaminergic

 

Re: Any solutions for Nardil weight gain?

Posted by Lamdage22 on June 8, 2020, at 11:21:51

In reply to Re: Any solutions for Nardil weight gain? SLS, posted by undopaminergic on June 8, 2020, at 9:18:35

You would risk your remission and sanity with this if you ask me. Bipolar and Stimulants with no Antipsychotic on board? Don't change a working system.

> Stimulants are a classic.

 

Re: Any solutions for Nardil weight gain?

Posted by undopaminergic on June 8, 2020, at 12:16:47

In reply to Re: Any solutions for Nardil weight gain?, posted by Lamdage22 on June 8, 2020, at 11:21:51

In my experience, stimulants can even be mood-stabilising. Sure, they reduce the need for sleep, as in (hypo)mania, and they can lift your mood, but this does not mean a switch to mania, it's just a drug effect that goes away upon cessation.

> Bipolar and Stimulants with no Antipsychotic on board? Don't change a working system.
>
> > Stimulants are a classic.
>
>

 

Re: Any solutions for Nardil weight gain?

Posted by sigismund on June 8, 2020, at 16:12:58

In reply to Any solutions for Nardil weight gain?, posted by SLS on June 8, 2020, at 8:52:05

>Is the weight gain with Nardil the result of increased appetite / caloric intake, metabolic changes, or both?

It would be good to know about the metabolic changes.

 

Re: Any solutions for Nardil weight gain? SLS

Posted by Phillipa on June 8, 2020, at 18:13:17

In reply to Any solutions for Nardil weight gain?, posted by SLS on June 8, 2020, at 8:52:05

Exercise as you know works wonders. Still lift weights? Rebuild your muscles as takes more calories to sustain muscle tissue

 

Re: Any solutions for Nardil weight gain? SLS

Posted by PCB on June 8, 2020, at 19:03:01

In reply to Any solutions for Nardil weight gain?, posted by SLS on June 8, 2020, at 8:52:05

Ive been on Nardil for 24 years and only found a few things limit the weight gain from Nardil. I have gained about 50 lbs but am 62. If I stop these things, Nardil slowly continues to cause me to gain weight indefinitely.

1. 30 minute of light weight lifting and 30 minutes of cardio 5 days a week
2. Eating small meals every 4 hours, including at night. I will typical wake up every 4 hours and have bread with olive oil. Meals should be 350 calories for me.
3. Eating at the same time every day
4. I eat 3 mandarins in the morning, salmon or sardines tomato and kale for lunch and dinner and bazzini raisin and peanut mix for 3:00 PM snack.
5. So I eat at 7AM, 11:30, 3:30 and 6 PM. I have bread at 10 PM, 1:00 AM and 4:00 AM. If I get hungry in between those times, I try to go for a walk outside to divert my appetite.
6. No processed food or candy or sweets ever for me. Guaranteed to put on 1 lbs for every box of cookies I eat and makes it hard to find healthy food tasty.

I just started TMS with hopes to lower my Nardil dose. But I am so treatment resistant, I doubt it will work.

Best for luck SLS

 

MAOI diet restriction! I forgot to mention

Posted by PCB on June 8, 2020, at 19:09:58

In reply to Any solutions for Nardil weight gain?, posted by SLS on June 8, 2020, at 8:52:05

P.S. Sardine, peanuts, raisins and citrus fruit are on some peoples MAOI diet restrictions list. I have lowered my Nardil dose and added small bits of lithium and lamictal to reduce my side effects by about 20%. So I have never had a hypertensive crisis. Please check with your doctor before trying my diet regarding the safety of these foods.

 

Re: MAOI diet restriction! I forgot to mention

Posted by PeterMartin on June 8, 2020, at 19:42:11

In reply to MAOI diet restriction! I forgot to mention, posted by PCB on June 8, 2020, at 19:09:58

I had to switch to Nardil from Marplan for 2yrs due to the shortage and was petrified about weight gain. I pretty much insisted that my doc let me trial metformin while on Nardil. In the 2yrs I was on both it kept it more or less weight neutral. I started at 216 and ended at 226ish. That's w/o being very active and not sticking to any sorta of diet (although I did have weight on my mind when deciding whether or not to eat).

Metformin has lots of benefits. If you can convince your doctor to let you get on it Id highly recommend it. There are a number of studies on scholar.google.com about preventing AP weight gain from the worst offenders (Zyprexa etc).

Topamax is another potential that I'm sure you're aware of. Side effects are difficult, it can make you worse moodwise, and it doesn't always work for weight loss after the first trial.

Other than those 2 though I honestly don't know if there are options. Perhaps Contrave which is an fda approved wt loss med containing low dose Naltrexone & Wellbutrin. Drugs.com reviews for that aren't very good though.

Nice to see a post from you.

 

You guys are the BEST!

Posted by SLS on June 8, 2020, at 20:25:00

In reply to Re: MAOI diet restriction! I forgot to mention, posted by PeterMartin on June 8, 2020, at 19:42:11

I started taking Nardil 5-6 weeks ago. I am beginning to feel really good. The last time I responded this well to treatment was in 1987. The amount of improvement is extremely significant. I felt best 2-3 days ago. If I had to put a number on it, I would say 35%. I've had two periods of worsening that lasted for about 1/2 day. That I recover is encouraging.

When I was a research patient in 1992-1993, the big boss, Robert M. Post, drew a diagram on an old piece of construction paper and a pencil to demonstrate the course of improvement in depression - especially for difficult cases. It looked like a saw-blade angling up diagonally - not like a staircase. 3 steps up and 1 step down. Amazingly, Dr. Post is still there and also publishing the Bipolar Network Newsletter.

In 1996, Lamictal was approved. On that day, all of the drugs that are necessary for me to get well (hopefully) were available. I came close in 2007. Right drugs, wrong dosages. That's a bit of a hard pill to swallow, but I don't find myself looking back in anger. I will be enormously grateful to a higher power if I finally recover. I would have preferred to begin life at age 36, but 60 ain't too bad.

This is what I'm taking now:

Nardil 75 mg/day
Nortriptyline 100 mg/day
Lithium 300 mg/day
Lamictal 300 mg/day.

Metformin sounds good. I'll have to sell the idea to my doctor, though. I asked him about it not too many weeks ago. He wasn't too keen on the idea. He suggested Topamax. I won't flood my brain with another drug that manipulates neural function just to prevent weight gain. I'll approach him again about the metformin.

Thanks again, guys.


- Scott

 

Re: You guys are the BEST!

Posted by SLS on June 8, 2020, at 20:28:14

In reply to You guys are the BEST!, posted by SLS on June 8, 2020, at 20:25:00

Oops.

I forgot to say that it was at the NIMH / NIH where I was a research patient. I was there for 9 months.


- Scott

 

Re: You guys are the BEST! SLS

Posted by sigismund on June 8, 2020, at 23:10:50

In reply to You guys are the BEST!, posted by SLS on June 8, 2020, at 20:25:00

Metformin is pretty benign in my experience and from what I have read, Scott.

 

Re: You guys are the BEST!

Posted by Lamdage22 on June 9, 2020, at 1:31:43

In reply to Re: You guys are the BEST! SLS, posted by sigismund on June 8, 2020, at 23:10:50

Metformin sure is less likely to destabilize you than Stimulants. To me weight loss effect isn't benign. It is much safer to try than any psychmed in my opinion.

 

Re: You guys are the BEST!

Posted by Lamdage22 on June 9, 2020, at 1:32:27

In reply to You guys are the BEST!, posted by SLS on June 8, 2020, at 20:25:00

Show him some evidence if you wan't to try!

 

Re: You guys are the BEST!

Posted by Englishman006! on June 9, 2020, at 4:18:46

In reply to Re: You guys are the BEST!, posted by Lamdage22 on June 9, 2020, at 1:32:27

I saw a documentary on why people age and what you can do about it. It so happens that rats given metformin have a longer life span than controls!! Whether this is also true for humans nobody knows!

 

Re: Does any one in particular stand out??

Posted by linkadge on June 9, 2020, at 21:05:30

In reply to Re: You guys are the BEST!, posted by Englishman006! on June 9, 2020, at 4:18:46

Kidding

Linkadge

 

Re: You guys are the BEST! SLS

Posted by ed_uk2010 on June 11, 2020, at 14:49:27

In reply to You guys are the BEST!, posted by SLS on June 8, 2020, at 20:25:00

Hi Scott,

Very pleased to hear you're feeling better. Your med combo is also looking a great deal slimmer, which pleases me I must say. I am glad you managed to get rid of the antipsychotics.

I'm still rather amazed at the apparent ease with which topiramate is prescribed off-label in the US. We consider it to be heavy on the side effects, but do use it quite a bit for prophylaxis of severe frequent migraine attacks, as well as for epilepsy (often as an add-on for partial seizures). It is not normally used by psychiatrists for any reason.

Metformin is generally safe and well-tolerated... but it can certainly cause an upset stomach and diarrhoea for those who are sensitive to it. A gradual introduction seems to improve its tolerability. The probability of nausea appears decreased by taking it with food. Use of modified-release products reduces the chance of nausea, but not diarrhoea. Of course, you may not be affected by either.

Metformin is not a reliable med for weight loss, in the sense that quite a lot of pts don't respond at all. On the other hand, small loses are common and some people respond really well. It's probably worth a try.

In non-diabetics, blood glucose levels are very minimally affected in most cases. This does not require close monitoring unless other drugs with a risk of hypoglycaemia are being taken alongside it.

Typically, a blood test will be done to assess renal function before starting metformin, unless one has been taken recently (urea, creatinine, electrolyte profile & calculated eGFR). Further blood tests for renal function are done occasionally during treatment. Unless there are risk factors or in the elderly, this would only need to be very occasional. If you become physically unwell during treatment for an unrelated reason esp. bad diarrhoea and vomiting due to a bug, you may wish to suspend the metformin and reintroduce it when you're better.

Hope this helps.

 

Re: You guys are the BEST! ed_uk2010

Posted by SLS on June 12, 2020, at 10:18:53

In reply to Re: You guys are the BEST! SLS, posted by ed_uk2010 on June 11, 2020, at 14:49:27

> Hi Scott,

Hi, Ed.

> Very pleased to hear you're feeling better. Your med combo is also looking a great deal slimmer,
>
> Hope this helps.

Very much! (As usual).

Your posts are complete and invaluable. I wish we saw your name appear on this board more often, but I hope one of the reasons why we don't is because you are doing well.

Thanks.

:-)


- Scott

 

Re: You guys are the BEST! SLS

Posted by ed_uk2010 on June 12, 2020, at 15:33:24

In reply to Re: You guys are the BEST! ed_uk2010, posted by SLS on June 12, 2020, at 10:18:53

Thanks Scott, I'm not doing too badly at all.

Mostly, I'm just busy with work etc, but I will certainly try to start contributing more again.

I'm pleased to hear that you found the information helpful :)

Take care.

 

Re: Any solutions for Nardil weight gain?

Posted by creepy on June 22, 2020, at 1:36:33

In reply to Any solutions for Nardil weight gain?, posted by SLS on June 8, 2020, at 8:52:05

Topiramate has always worked great for me to cut the craving for carbohydrates. Problem is I get issues with coordination, eyelid twitches and some pretty dumb thinking on it at times. But compared to the health issues from being seriously overweight its a bargain.

 

Re: Any solutions for Nardil weight gain?

Posted by Lamdage22 on June 22, 2020, at 1:42:35

In reply to Re: Any solutions for Nardil weight gain?, posted by creepy on June 22, 2020, at 1:36:33

I still vote for Metformin. It is really clean. I can't afford cognitive deficits.

 

Re: Any solutions for Nardil weight gain?

Posted by stargazer2 on July 7, 2020, at 14:29:42

In reply to Re: Any solutions for Nardil weight gain?, posted by Lamdage22 on June 22, 2020, at 1:42:35

I have also gained weight on Nardil but I am too afraid of adding anything to something that works. Im probably 15 lbs more than when I started Nardil. I take the lowest dose for me which is 45 rather than 60, which has caused more than 15 lbs gain. I try and exercise but am not very good about establishing good routines that I know are invaluable for me and would definately improve my body weight and condition. Sadly, my motivation tends to be non-existent.
I think having had Ketamine IV a year ago has made my meds work better. It may also be taking DL-Phenylalanine, which has eliminated suicicidal thinking, which is a red flag symptom for my worsening depression.
Meds: Nardil 45 mg q am (60 is ideal)
Ritalin, 5 mg, up to TID (usually 2x/day)
Seroquel 50 mg q pm for sleep
Lithium 300 ER, 1x/wk (or more if
depression slips)
DL Phenylalanine 500 mg 1-2/wk

As you can probably tell my goal is the lowest dose of each med, more has never helped me except 60 mg Nardil might be better but with more wgt gain.


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