![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by MB on August 9, 2000, at 12:52:15
Hey, for the past eight weeks, I've been on a combo
of Buspar and Wellbutrin. At first, the WB really wigged me out, but I was determined to ride it out because I was so sick of the weight gain, sexual dysfunction, and fatigue I had with Paxil. WB seemed like the best drug to take to avoid those three side effects. Well, because of the irritability and speediness, I added Buspar to the regimen. The first few weeks were good: motivated, energized, not depressed. Lately, though some scary things have been happening. Some problems that I'd had as a kid have been comming back. For example, I get severe rages. Sometimes the simplest things set me off, and it's all I can do to keep from screaming and destroying things (including myself). It's like I want to break dishes and windows, and pull my hair out. It's bad. Also, I've had a recurrence of some tics I had as a kid. Nose wiggling, mouth wiggling, moving my diaphram up and down, etc. It's scary. I don't know if the drugs are causing these symptoms, but it really seems like they are. I'm scared of developing a permanent movement disorder. Today, I'm going to make an appointment to see my doc. In the meantime, does anybody have any comments?
Posted by MB on August 9, 2000, at 13:01:43
In reply to Which SSRI Causes Least Weight Gain, posted by MB on August 9, 2000, at 12:52:15
Oh, yeah. *DUH!!!* The reason for the title of the thread: With these afformentioned side effects, I'm thinking that my doc might want to switch meds. Does anybody know which SSRIs cause the least weight gain and fatigue? Gained weight (obviously) on Paxil. I've taken a combo of Effexor and Zoloft before. I was fatigued and slow on the combo(and stayed about 10 lbs. overweight as opposed to 20 lbs. on Paxil). I wonder if Effexor without the Zoloft might be less draining on my energy and metabolism.
Posted by Sunnely on August 9, 2000, at 22:03:38
In reply to Re: Which SSRI Causes Least Weight Gain, posted by MB on August 9, 2000, at 13:01:43
Sorry, I can't tell you which antidepressant is best for you with regard to avoiding weight gain. Everyone reacts differently to medications. That aside, here's the skinny on SSRI (and other atypical antidepressants)-induced weight gain. This is not etched in stone!
1. Comparing the SSRIs Prozac, Zoloft, and Paxil: a] Prozac was associated with a slight weight loss in the short-term treatment and weight neutral in the long-term treatment; b] Zoloft was associated with a nonsignificant weight gain, and essentially weight-neutral in the short-term and long-term treatment, respectively; c] Paxil was associated with significant weight gain. To summarize, there appears to be more early weight loss with Prozac than Zoloft and both remain relatively weight-neutral over time. There is a significantly greater risk of weight gain with Paxil.
2. Results from the short-term clinical trials of Celexa indicate that it does not produce significant weight gain or loss. Long-term treatment (1 year) with Celexa was associated with a mean weight gain of 1.5 kilogram, which was accompanied by a decrease in symptoms of reduced appetite. Little information is available on Luvox.
3. The possible explanation for SSRI-induced weight gain are: a] recovery from depression or clinical improvement, b] appetite increase/carbohydrate craving, and c] changes in serotonin 5HT2C receptor activity. However, there are no definitive studies to explain the exact cause of weight gain as a side effect of SSRIs.
4. Patients maintained on Wellbutrin, and later on Wellbutrin SR gained minimal or no weight gain. In fact, patients who received either drugs had weight loss, although relatively small. The exact reason why patients lose weight on Wellbutrin (bupropion) is not known. It should be noted, however, that the drug is structurally related to a well-known weight-loss drug, Tenuate (diethylpropion).
5. It appears from data collected from clinical trials that weight gain from Effexor may not be particularly a big issue. Effexor, at least in the short-term, is not associated with weight gain. On the other hand, very little is known about the effect of Effexor on weight in the long-term. It is interesting to note that Effexor and Meridia (sibutramine), a weight-loss drug, have somewhat similar effects on norepinephrine and serotonin. Both drugs have been reported to increase blood pressure in some patients.
6. There is some convincing evidence that Serzone may be relatively weight-neutral both in the short- and long-term treatment. Compared to the SSRIs, it was suggested that Serzone may be less likely to cause weight gain in long-term treatment. Serzone's lack of ability to cause weight gain may be due to the effects of its metabolite, m-chlorphenylpiperazine (mCPP). In studies, administration of mCPP decreased appetite and cause weight loss.
7. Weight gain with Remeron appears to be inversely related to the dose based on the European and US studies. Weight gain from Remeron appears to be due to increased appetite which in turn is related to its blocking effect on the histamine (H1) receptors. When exceeding Remeron's dose of 15 mg/day, the H1 receptors become saturated and other receptor effects, such as increased release of serotonin and norepinephrine predominate, and enhanced appetite and weight gain may be less of an issue. An analysis of 4 US studies showed that most of the weight gain experienced with Remeron tends to take place during the first 4 weeks of treatment.
8. Unfortunately, once patients gain weight, as long as they continue on the antidepressants, they may have trouble losing it, even with dieting and vigorous exercise.
9. The use of appetite suppressant drugs such as Tenuate (diethylpropion) or Fastin (phentermine) may help. The occurence of serotonin syndrome is a concern when combined with the SSRIs. Meridia is contraindicated with the use of SSRIs, and Xenical (orlistat) may cause objectionable side effects such as diarrhea.
10. Other drugs purported to curb the weight gain of antidepressant treatment include the H2 blockers such as famotidine (Pepcid) and cimetidine (Tagamet); psychostimulants; T3 (Cytomel); naltrexone (Revia); and topiramate (Topamax). The main problem is that none of these strategies has been tested systematically. They are derived primarily from anecdotal observations and case series.
Posted by sweetmarie on April 5, 2001, at 16:27:06
In reply to The Skinny on SSRI- (and others) induced wt gain, posted by Sunnely on August 9, 2000, at 22:03:38
> Sorry, I can't tell you which antidepressant is best for you with regard to avoiding weight gain. Everyone reacts differently to medications. That aside, here's the skinny on SSRI (and other atypical antidepressants)-induced weight gain. This is not etched in stone!
>
> 1. Comparing the SSRIs Prozac, Zoloft, and Paxil: a] Prozac was associated with a slight weight loss in the short-term treatment and weight neutral in the long-term treatment; b] Zoloft was associated with a nonsignificant weight gain, and essentially weight-neutral in the short-term and long-term treatment, respectively; c] Paxil was associated with significant weight gain. To summarize, there appears to be more early weight loss with Prozac than Zoloft and both remain relatively weight-neutral over time. There is a significantly greater risk of weight gain with Paxil.
>
> 2. Results from the short-term clinical trials of Celexa indicate that it does not produce significant weight gain or loss. Long-term treatment (1 year) with Celexa was associated with a mean weight gain of 1.5 kilogram, which was accompanied by a decrease in symptoms of reduced appetite. Little information is available on Luvox.
>
> 3. The possible explanation for SSRI-induced weight gain are: a] recovery from depression or clinical improvement, b] appetite increase/carbohydrate craving, and c] changes in serotonin 5HT2C receptor activity. However, there are no definitive studies to explain the exact cause of weight gain as a side effect of SSRIs.
>
> 4. Patients maintained on Wellbutrin, and later on Wellbutrin SR gained minimal or no weight gain. In fact, patients who received either drugs had weight loss, although relatively small. The exact reason why patients lose weight on Wellbutrin (bupropion) is not known. It should be noted, however, that the drug is structurally related to a well-known weight-loss drug, Tenuate (diethylpropion).
>
> 5. It appears from data collected from clinical trials that weight gain from Effexor may not be particularly a big issue. Effexor, at least in the short-term, is not associated with weight gain. On the other hand, very little is known about the effect of Effexor on weight in the long-term. It is interesting to note that Effexor and Meridia (sibutramine), a weight-loss drug, have somewhat similar effects on norepinephrine and serotonin. Both drugs have been reported to increase blood pressure in some patients.
>
> 6. There is some convincing evidence that Serzone may be relatively weight-neutral both in the short- and long-term treatment. Compared to the SSRIs, it was suggested that Serzone may be less likely to cause weight gain in long-term treatment. Serzone's lack of ability to cause weight gain may be due to the effects of its metabolite, m-chlorphenylpiperazine (mCPP). In studies, administration of mCPP decreased appetite and cause weight loss.
>
> 7. Weight gain with Remeron appears to be inversely related to the dose based on the European and US studies. Weight gain from Remeron appears to be due to increased appetite which in turn is related to its blocking effect on the histamine (H1) receptors. When exceeding Remeron's dose of 15 mg/day, the H1 receptors become saturated and other receptor effects, such as increased release of serotonin and norepinephrine predominate, and enhanced appetite and weight gain may be less of an issue. An analysis of 4 US studies showed that most of the weight gain experienced with Remeron tends to take place during the first 4 weeks of treatment.
>
> 8. Unfortunately, once patients gain weight, as long as they continue on the antidepressants, they may have trouble losing it, even with dieting and vigorous exercise.
>
> 9. The use of appetite suppressant drugs such as Tenuate (diethylpropion) or Fastin (phentermine) may help. The occurence of serotonin syndrome is a concern when combined with the SSRIs. Meridia is contraindicated with the use of SSRIs, and Xenical (orlistat) may cause objectionable side effects such as diarrhea.
>
> 10. Other drugs purported to curb the weight gain of antidepressant treatment include the H2 blockers such as famotidine (Pepcid) and cimetidine (Tagamet); psychostimulants; T3 (Cytomel); naltrexone (Revia); and topiramate (Topamax). The main problem is that none of these strategies has been tested systematically. They are derived primarily from anecdotal observations and case series.
Re. Anti-depressants and weight gain.I have been on two Tricyclics over the years, both of which cited weight gain as a common side effect. I didn`t gain weight on either.
The only anti-depressant that I have gained weight on is Nardil (which I think is fairly notorious for this). I gained a lot of weight - 3 stone (I don`t know what that is in the States, but it`s 3 dress sizes). I totally hate this - I`m not naturally a big person, I`ve always been slim.
My psychiatrist reckons that all psychiatric medications can cause weight gain (with the exception of Prozac), and just because weight gain is a stated side-effect, this doesn`t mean that it will necessarily happen. I don`t know whether she`s right or not.
I`m shortly to go onto Remeron (Zispin in this country), which also cites weight gain as a possible side-effect. Before I do this, I have to come off Nardil and be clear for a week. What concerns me is that I won`t lose the Nardil weight, and just pile on the pounds on top of this when I embark on the Remeron. It`s to be part of a combination - Remeron and Effexor. Effexor cites weight loss as a possible side-effect, and when I was on it before I did lose weight. Could the one countereact the other?
Has anyone got any comments/ideas/experiences/info in general?
I`d be grateful to hear anyones views.
Cheers,
Anna.
Posted by LETITIA MURPHY on June 18, 2001, at 3:53:14
In reply to Re: The Skinny on SSRI- (and others) induced wt gain, posted by sweetmarie on April 5, 2001, at 16:27:06
Interesting you should relate this Wellbutrin to Tenuate because I take this sometimes as well as my anti-depressant for get up and go. How much is Wellbutrin? And how much is normally prescibed.
> > Sorry, I can't tell you which antidepressant is best for you with regard to avoiding weight gain. Everyone reacts differently to medications. That aside, here's the skinny on SSRI (and other atypical antidepressants)-induced weight gain. This is not etched in stone!
> >
> > 1. Comparing the SSRIs Prozac, Zoloft, and Paxil: a] Prozac was associated with a slight weight loss in the short-term treatment and weight neutral in the long-term treatment; b] Zoloft was associated with a nonsignificant weight gain, and essentially weight-neutral in the short-term and long-term treatment, respectively; c] Paxil was associated with significant weight gain. To summarize, there appears to be more early weight loss with Prozac than Zoloft and both remain relatively weight-neutral over time. There is a significantly greater risk of weight gain with Paxil.
> >
> > 2. Results from the short-term clinical trials of Celexa indicate that it does not produce significant weight gain or loss. Long-term treatment (1 year) with Celexa was associated with a mean weight gain of 1.5 kilogram, which was accompanied by a decrease in symptoms of reduced appetite. Little information is available on Luvox.
> >
> > 3. The possible explanation for SSRI-induced weight gain are: a] recovery from depression or clinical improvement, b] appetite increase/carbohydrate craving, and c] changes in serotonin 5HT2C receptor activity. However, there are no definitive studies to explain the exact cause of weight gain as a side effect of SSRIs.
> >
> > 4. Patients maintained on Wellbutrin, and later on Wellbutrin SR gained minimal or no weight gain. In fact, patients who received either drugs had weight loss, although relatively small. The exact reason why patients lose weight on Wellbutrin (bupropion) is not known. It should be noted, however, that the drug is structurally related to a well-known weight-loss drug, Tenuate (diethylpropion).
> >
> > 5. It appears from data collected from clinical trials that weight gain from Effexor may not be particularly a big issue. Effexor, at least in the short-term, is not associated with weight gain. On the other hand, very little is known about the effect of Effexor on weight in the long-term. It is interesting to note that Effexor and Meridia (sibutramine), a weight-loss drug, have somewhat similar effects on norepinephrine and serotonin. Both drugs have been reported to increase blood pressure in some patients.
> >
> > 6. There is some convincing evidence that Serzone may be relatively weight-neutral both in the short- and long-term treatment. Compared to the SSRIs, it was suggested that Serzone may be less likely to cause weight gain in long-term treatment. Serzone's lack of ability to cause weight gain may be due to the effects of its metabolite, m-chlorphenylpiperazine (mCPP). In studies, administration of mCPP decreased appetite and cause weight loss.
> >
> > 7. Weight gain with Remeron appears to be inversely related to the dose based on the European and US studies. Weight gain from Remeron appears to be due to increased appetite which in turn is related to its blocking effect on the histamine (H1) receptors. When exceeding Remeron's dose of 15 mg/day, the H1 receptors become saturated and other receptor effects, such as increased release of serotonin and norepinephrine predominate, and enhanced appetite and weight gain may be less of an issue. An analysis of 4 US studies showed that most of the weight gain experienced with Remeron tends to take place during the first 4 weeks of treatment.
> >
> > 8. Unfortunately, once patients gain weight, as long as they continue on the antidepressants, they may have trouble losing it, even with dieting and vigorous exercise.
> >
> > 9. The use of appetite suppressant drugs such as Tenuate (diethylpropion) or Fastin (phentermine) may help. The occurence of serotonin syndrome is a concern when combined with the SSRIs. Meridia is contraindicated with the use of SSRIs, and Xenical (orlistat) may cause objectionable side effects such as diarrhea.
> >
> > 10. Other drugs purported to curb the weight gain of antidepressant treatment include the H2 blockers such as famotidine (Pepcid) and cimetidine (Tagamet); psychostimulants; T3 (Cytomel); naltrexone (Revia); and topiramate (Topamax). The main problem is that none of these strategies has been tested systematically. They are derived primarily from anecdotal observations and case series.
>
>
> Re. Anti-depressants and weight gain.
>
> I have been on two Tricyclics over the years, both of which cited weight gain as a common side effect. I didn`t gain weight on either.
>
> The only anti-depressant that I have gained weight on is Nardil (which I think is fairly notorious for this). I gained a lot of weight - 3 stone (I don`t know what that is in the States, but it`s 3 dress sizes). I totally hate this - I`m not naturally a big person, I`ve always been slim.
>
> My psychiatrist reckons that all psychiatric medications can cause weight gain (with the exception of Prozac), and just because weight gain is a stated side-effect, this doesn`t mean that it will necessarily happen. I don`t know whether she`s right or not.
>
> I`m shortly to go onto Remeron (Zispin in this country), which also cites weight gain as a possible side-effect. Before I do this, I have to come off Nardil and be clear for a week. What concerns me is that I won`t lose the Nardil weight, and just pile on the pounds on top of this when I embark on the Remeron. It`s to be part of a combination - Remeron and Effexor. Effexor cites weight loss as a possible side-effect, and when I was on it before I did lose weight. Could the one countereact the other?
>
> Has anyone got any comments/ideas/experiences/info in general?
>
> I`d be grateful to hear anyones views.
>
> Cheers,
>
> Anna.
Posted by grapebubblegum on June 19, 2001, at 12:58:02
In reply to Re: The Skinny on SSRI- (and others) induced wt gain, posted by LETITIA MURPHY on June 18, 2001, at 3:53:14
I've said this before (however, I have not updated you guys on the weight loss I am so pleased with) and I'll say it again:
I stopped taking Paxil about a month or two ago and I have never felt better. I did not realize what was making me feel so sluggish, but I think the Paxil was messing with my blood sugar or something. I think my weight stayed the same on Paxil but I was trying hard to lose weight and not getting anywhere, like being on a treadmill. I was eating more sweets than a normal person should, I have to admit.
Now, I have lost a total of 8 lbs. YAY! Of course I have had to watch what I eat and rein in my appetite at times but it is EASY, not HARD to do now. I really need to lose weight so I am delighted to be on my way toward my goal. I weighed in after the first few weeks off Paxil and had lost 4 lbs. Two weeks later I weighed in and was shocked to see another 4 lbs. gone.
I'm sure the Paxil people, if they are reading this, do not appreciate my comments.
The only other med I am taking is a small dose of clonazepam three times per day. I would think that would uninhibit one's appetite rather than suppress it, if either one, so I am not considering the clonazepam to be a factor. I could be wrong. All I know is that I am losing weight and delighted about it.
Posted by Lorraine on June 20, 2001, at 0:02:35
In reply to Yay for me! 8 lbs. lost, posted by grapebubblegum on June 19, 2001, at 12:58:02
Yeah! Weight loss is good. Lot of SSRI's cause weight gain. Effexor caused me to gain 35 lbs and I gained it by eating a lot of carbs--which Effexor made me crave. I lost mine when I went off Effexor on a low carb diet.
Posted by Willow on June 20, 2001, at 13:35:21
In reply to Re: Yay for me! 8 lbs. lost, posted by Lorraine on June 20, 2001, at 0:02:35
> Yeah! Weight loss is good. Lot of SSRI's cause weight gain. Effexor caused me to gain 35 lbs and I gained it by eating a lot of carbs--which Effexor made me crave. I lost mine when I went off Effexor on a low carb diet.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.