Posted by Elizabeth on August 11, 2001, at 23:51:28
In reply to Medications and side effects..., posted by CLK on August 10, 2001, at 8:12:47
> My concern is that I think I may need to take meds again, but my research indicates two side effects common to most meds tha I have grave concerns about.
>
> 1 - Weight gain. I am already significantly overweight. The last thing I need is a medication therapy that will cause me to gain weight.
>
> 2 - Sexual side effects. I cannot imagine telling my husband, "Well, babe the good news is that you get rid of a lunatic wife, but you won't be having sex. Because my medication will kill my sex drive."
>
> Are these two side effects as prominent and problematic as they appear?It depends on the drug. Selective serotonin reuptake inhibitors (Prozac, Zoloft, Paxil, Luvox, Celexa) seem to be the worst offenders in the area of sexual dysfunction. Some tricyclics, such as amitriptyline (Elavil) and clomipramine (Anafranil), commonly cause sexual problems, while others, like desipramine (Norpramin) and nortriptyline (Pamelor) usually don't. MAOIs, especially Nardil, can cause sexual problems too, as can the mixed reuptake inhibitor Effexor (venlafaxine). The miscellaneous antidepressants Remeron (mirtazapine) and Serzone (nefazodone) are unlikely to cause this type of side effect. Remeron or Wellbutrin can also be added to an SSRI, and often this approach will reverse or alleviate the sexual side effects.
As far as weight gain goes, some people gain weight on SSRIs, but some don't, and it's not entirely clear to what extent the weight gain is caused directly by the drugs. The tricyclics are probably worse, although there is quite a bit of variation among the tricyclics. (Desipramine and nortriptyline generally have the mildest side effect profiles of the tricyclics, and they are probably the least likely to cause weight gain.) The MAOI phenelzine (Nardil) is associated with a high rate of weight gain; Parnate (tranylcypromine), another MAOI, is unlikely to cause weight gain. Remeron does cause a lot of weight gain for a lot of people, but this isn't universal and may become less of a problem as you increase the dose. FWIW, when I tried it I started at 30 mg and increased it rapidly to 75 mg, and I never had any weight problems on it. The sedation is definitely more of a problem at low doses (7.5-15 mg), and the weight gain may be also. Serzone is probably unlikely to cause weight gain, although experience with this drug is relatively limited (it just never really caught on).
-elizabeth
poster:Elizabeth
thread:74452
URL: http://www.dr-bob.org/babble/20010809/msgs/74722.html