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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Trepanist on September 22, 2008, at 22:12:48
Hi all. I've been on Lexapro now for a few years and will probably continue for the rest of my life. I've gained about 70 lbs, which I attribute to a course of Risperdal :(
I desperately need to lose this weight for obvious reasons, but am concerned about what to expect. All of my doctors say that there's no metabolic change from the drug, it's just that I eat more. So, it follows that simple diet and exercise should do that trick (I'm lacking both).
Please let me know what your experiences have been.
Thanks.
Posted by Phillipa on September 22, 2008, at 23:31:55
In reply to Do people LOSE weight while on an SSRI?, posted by Trepanist on September 22, 2008, at 22:12:48
Welcome to babble see that you are new. Lots of lexapro users here and hopefully one will answer your question. Glad to have you. Phillipa
Posted by yxibow on September 23, 2008, at 1:57:14
In reply to Do people LOSE weight while on an SSRI?, posted by Trepanist on September 22, 2008, at 22:12:48
> Hi all. I've been on Lexapro now for a few years and will probably continue for the rest of my life. I've gained about 70 lbs, which I attribute to a course of Risperdal :(
>
> I desperately need to lose this weight for obvious reasons, but am concerned about what to expect. All of my doctors say that there's no metabolic change from the drug, it's just that I eat more. So, it follows that simple diet and exercise should do that trick (I'm lacking both).
Risperdal, not by my experience, but by my experience with Seroquel, is potentially a weight gaining drug, so that is probably a potential culprit.Lexapro is supposed to be weight neutral.
If you experienced any metabolic change, you should have a few key tests for this done by a GP for diabetes II and cholesterol, basically the lipid panel I think.
But yes, it is basically diet and exercise -- and I'm experiencing the same problem with Seroquel only its extremely hard to explain why I can't do what I used to do at my gym at this point.
I'm trying to reduce my intake and I hope to gradually walk and do something else, I don't know what, within my limitations at this point.
But if you can join a local or chain gym (whatever you do on those I would bypass the hard sell, anyhow that's a sidebar), or the Y or some public place or something at work, would help.
Weight lifting, starting gradually, actually is a good way to burn calories.
And just walking for an hour a day at least does something -- it may be very boring or not, that could be mitigated by going to some other place that you don't normally walk around, but its a start.
So yes, I think it is at least partially that you eat more and don't realize it. I am really trying to cut down on cereal and find it hard in the morning after a Seroquel/amytriptiline haze when one wants to devour things.
It may be hard to calculate it entirely, but a simple log of what you typically eat in a day, and then look up, there are plenty of places including the USDA site for calories, they have like 10,000 foods measured, and average it.
If you eat less than that amount, and maybe subtract a little for a metabolic change, you will lose weight. The calorie count is your maintenance calories, the amount that keeps your weight where it is, give or take. Eating less than that will make you lose calories over time.
I know its a hard thing to do, believe me, I've been through it several times with medication.
-- best wishes
Jay
Posted by Trepanist on September 23, 2008, at 2:43:17
In reply to Re: Do people LOSE weight while on an SSRI? » Trepanist, posted by yxibow on September 23, 2008, at 1:57:14
> > Hi all. I've been on Lexapro now for a few years and will probably continue for the rest of my life. I've gained about 70 lbs, which I attribute to a course of Risperdal :(
> >
> > I desperately need to lose this weight for obvious reasons, but am concerned about what to expect. All of my doctors say that there's no metabolic change from the drug, it's just that I eat more. So, it follows that simple diet and exercise should do that trick (I'm lacking both).
>
>
> Risperdal, not by my experience, but by my experience with Seroquel, is potentially a weight gaining drug, so that is probably a potential culprit.
>
> Lexapro is supposed to be weight neutral.
>
> If you experienced any metabolic change, you should have a few key tests for this done by a GP for diabetes II and cholesterol, basically the lipid panel I think.
>
> But yes, it is basically diet and exercise -- and I'm experiencing the same problem with Seroquel only its extremely hard to explain why I can't do what I used to do at my gym at this point.
>
> I'm trying to reduce my intake and I hope to gradually walk and do something else, I don't know what, within my limitations at this point.
>
> But if you can join a local or chain gym (whatever you do on those I would bypass the hard sell, anyhow that's a sidebar), or the Y or some public place or something at work, would help.
>
> Weight lifting, starting gradually, actually is a good way to burn calories.
>
> And just walking for an hour a day at least does something -- it may be very boring or not, that could be mitigated by going to some other place that you don't normally walk around, but its a start.
>
> So yes, I think it is at least partially that you eat more and don't realize it. I am really trying to cut down on cereal and find it hard in the morning after a Seroquel/amytriptiline haze when one wants to devour things.
>
> It may be hard to calculate it entirely, but a simple log of what you typically eat in a day, and then look up, there are plenty of places including the USDA site for calories, they have like 10,000 foods measured, and average it.
>
> If you eat less than that amount, and maybe subtract a little for a metabolic change, you will lose weight. The calorie count is your maintenance calories, the amount that keeps your weight where it is, give or take. Eating less than that will make you lose calories over time.
>
> I know its a hard thing to do, believe me, I've been through it several times with medication.
>
> -- best wishes
>
> Jay
>Thanks Jay. I just had my annual physical and I failed all three of the metabolic panel. I don't have metabolic syndrome yet, but am on my way, hence the urgency. Anyway, I appreciate the re-assurance; it will give me an added incentive to work out.
Mark
Posted by elanor roosevelt on September 23, 2008, at 3:19:59
In reply to Re: Do people LOSE weight while on an SSRI? » yxibow, posted by Trepanist on September 23, 2008, at 2:43:17
turn it into muscle as much as you can
it's not easy to lose weight while on the medsgood luck
Posted by yxibow on September 23, 2008, at 5:23:07
In reply to Re: Do people LOSE weight while on an SSRI? » yxibow, posted by Trepanist on September 23, 2008, at 2:43:17
> Thanks Jay. I just had my annual physical and I failed all three of the metabolic panel. I don't have metabolic syndrome yet, but am on my way, hence the urgency. Anyway, I appreciate the re-assurance; it will give me an added incentive to work out.
Exactly -- it is an added incentive. I'm sorry you failed the panel -- although to what extent is always the case on the ranges. But that's technical. If you feel the need to do so and your insurance provides it, maybe your GP can send you to an endocrinologist to further explore any options and tests.The good news if you just started to have lipid issues is that you may have several years before it can develop into a worse scenario -- and in those times, yes, it is an incentive and perfectly feasible.
You don't have to lose all 70 pounds I think -- just some of it to pass another panel test and feel better about yourself, if your insurance affords or you are concerned, I think some doctors would think you should monitor that at a higher rate. But that's up to your GP or a endo.
-- best wishesJay
Posted by Racer on September 23, 2008, at 11:02:59
In reply to Do people LOSE weight while on an SSRI?, posted by Trepanist on September 22, 2008, at 22:12:48
Welcome to Babble, Mark! It is a great place, and there are lots of great people here.
All the SSRIs potentially cause weight gain. Some people are more vulnerable to it than others -- I'm especially vulnerable to weight gain from meds, for example, in large part because I'm underweight to begin with. Serotonin is the main neurotransmitter involved in feeding behaviors, which includes the physical parts like gut motility and the signals your body gives that you've satisfied your hunger. For some people, diet and exercise just aren't going to make a lot of difference in that regard. If the Lexapro is a big contributor to your weight gain, I'd strongly urge you to get a referral to a good dietitian who has experience with weight gain related to psychotropic medications. Plan on working closely with him/her, probably at least twice a month.
The Risperdal, of course, is probably a much more active participant in your weight gain, so some will probably come off after stopping that. (I'm assuming you are, by the way. If not, that's moot.)
Some medications can mitigate the weight gain, and aid in losing the weight while on these meds. Topomax is probably the best choice these days, although Zelnorm -- no longer on the market -- was the only medication I know of which addressed the underlying issue with the SSRIs directly. Another option is to try one of the OTC acid reducers -- they help ease the GI discomfort which adds to the obesogenic effects for a lot of people. It's well worth a try.
Yxibow -- who knows I think he's a smart cookie -- had a great suggestion, and it's one that I make frequently: keep a food journal. Write down EVERYTHING you eat, and write it down accurately and completely. Measure portions, find out how much you're actually eating. You may find that you're eating more than you're aware. (Far more often the case than you might think...) Also look at your food choices and how often you eat: about 65% of your calories should come from carbs, for example, and you should be eating at least every 2.5 to 3 hours, because the idea is to stay between about 3 and 6 on a hunger scale where 1 is so hungry you feel weak and dizzy and 10 is so stuffed you literally cannot stand up. So, three meals, three snacks, and a very minimum of 1200 calories per day. (As in -- you probably need more like 1500 calories per day, but never, ever, ever go below 1200.) Five servings of veggies and two or three servings of fruits per day. And so on... (Yes, more than a year of nutritional counseling and college courses in nutritional sciences...)
I hope that helps, and best luck!
Posted by Trepanist on September 23, 2008, at 12:03:29
In reply to Re: Do people LOSE weight while on an SSRI? » Trepanist, posted by Racer on September 23, 2008, at 11:02:59
Wow, thanks for the detailed response Racer! i just started seeing a this guy, actually an MD, about xhanging my eating habits. Will mention this stuff to him. Thanks again.
Mark
Posted by raisinb on September 23, 2008, at 15:01:02
In reply to Do people LOSE weight while on an SSRI?, posted by Trepanist on September 22, 2008, at 22:12:48
I have, both times I've been on Zoloft. The first time, I was on it by itself; the second, with Wellbutrin (which is known for causing weight loss).
I don't know how to describe it exactly, but it affected my appetite just like it affected my libido. In other words, the physical urges (sex, hunger) could be activated, and were, but it was like my brain just wasn't worried about doing anything about them. It killed the emotional, gratification-searching part of both of those drives. So my stomach would rumble, but I just felt too unworried to want to eat.
I don't know that that's a very common side effect of Zoloft, though.
Posted by Phillipa on September 23, 2008, at 20:48:43
In reply to Re: Do people LOSE weight while on an SSRI? » Trepanist, posted by raisinb on September 23, 2008, at 15:01:02
I guess I just don't gain weight on SSRI's . I'd be more inclined to blame the resperidol. Only my opinion. Love Phillipa
Posted by desolationrower on September 23, 2008, at 21:01:30
In reply to Re: Do people LOSE weight while on an SSRI? » raisinb, posted by Phillipa on September 23, 2008, at 20:48:43
I lost 10 lbs on citalopram. I am skinny to begin with (trying to gain weight usually.) I think mostly i was less interested in food i was less interested in everything. I was on it for maybe 8 weeks.
-D/R
Posted by Mirabella on September 24, 2008, at 2:52:58
In reply to Re: Do people LOSE weight while on an SSRI?, posted by desolationrower on September 23, 2008, at 21:01:30
SSRIs consistently caused me to gain weight and made it difficult to lose weight. Now that I'm off them, the weight has come off as dramatically as it came on when I started the SSRIs.
Posted by Racer on September 24, 2008, at 13:43:44
In reply to Re: Do people LOSE weight while on an SSRI?, posted by desolationrower on September 23, 2008, at 21:01:30
> I lost 10 lbs on citalopram. I am skinny to begin with (trying to gain weight usually.) I think mostly i was less interested in food i was less interested in everything. I was on it for maybe 8 weeks.
> -D/RThe thing with any of the serotinergic medications is that they generally do cause some initial weight LOSS, which is why they were thought to be so great at first. The short term nature of the studies done showed a tendency towards promoting weight loss.
More recent, longer term studies, however, have revealed a pattern of weight GAIN emerging after four to six months on the medications. What seems to happen is a down-regulation of the 5HTc receptors in the digestive system, after a period of increased stimulation. Kinda like the little receptors are saying, "Oh, it's you again." At that point, weight gain begins, and tends to continue.
For some people, taking an OTC acid reducer can help control the weight gain. It relieves the GI irritation which can be perceived as hunger. That's helped me, when I've taken it.
Hope that's helpful for someone.
Posted by Tony P on September 27, 2008, at 20:32:50
In reply to About SRI weight gain..., posted by Racer on September 24, 2008, at 13:43:44
> More recent, longer term studies, however, have revealed a pattern of weight GAIN emerging after four to six months on the medications. [snip] At that point, weight gain begins, and tends to continue.
That's *very* interesting. I've been on Cymbalta, which I believe has an SRI component (?), about six months now, and a couple of months ago started to gain weight seriously. I was already overweight from Remeron and lack of exercise/poor diet.
Do some of these A/D's stimulate carb. cravings as well as have a direct metabolic effect? I've had a problem with cookie addiction ;-) for years, but it seems worse lately.
BTW, I think I must be one of the few people who _gained_ weight on Wellbutrin -- I believe it generally produces weight loss. My depression had led to a total lack of interest in food, to the despair of my family of gourmet cooks, and I was somewhat under my usual weight when I started taking it. On WB, my zest for food returned along with my zest for life generally, and I gained weight quite sharply. Too bad I also went hypomanic on it, but it was fun while it lasted (for me at any rate).
This is the end of the thread.
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