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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Tom Twilight on February 3, 2006, at 15:44:37
I'm currently on 60mgs of Marplan, and I'm gaining weight from it, I'm heavier than I've ever been :(
This really affects my confidence, which is bad when you have Social Anxiety!
I take quite of lot of exersise, although I also eat quite a lot.
Is there anything that counteracts the MAOI weight gain or diminished appitite
Stimulants are out because I live in the UK
Posted by TylerJ on February 3, 2006, at 15:57:29
In reply to MAOI Weight Gain-Does anything help?, posted by Tom Twilight on February 3, 2006, at 15:44:37
Some docs prescribe Topomax with ssri's-I'm pretty sure it would be okay with marplan. It's an anticonvulsant and is also used for bipolar depression, anyway many people seem to lose a lot of weight on it. Most AD's cause weight gain-I've delt with it for 20 plus years myself-Topomax didn't help me. The only thing that did help me was joining weight watchers and exercise. Good Luck!
TylerJ
Posted by ed_uk on February 4, 2006, at 11:55:26
In reply to MAOI Weight Gain-Does anything help?, posted by Tom Twilight on February 3, 2006, at 15:44:37
Hi Tom
You could ask your GP to prescribe orlistat (Xenical) if you're clinically overweight. It reduces the absorption of fat from the gut.......but it does tend to cause diarrhea. The diarrhea can be minimised by sticking to a low fat diet.
Ed
Posted by Racer on February 4, 2006, at 12:20:32
In reply to Re: MAOI Weight Gain-Does anything help? » Tom Twilight, posted by ed_uk on February 4, 2006, at 11:55:26
> Hi Tom
>
> You could ask your GP to prescribe orlistat (Xenical) if you're clinically overweight. It reduces the absorption of fat from the gut.......but it does tend to cause diarrhea. The diarrhea can be minimised by sticking to a low fat diet.
>
> EdMeridia came onto my radar a short time ago, and I wonder if you've had any experience around it? I know it was originally created as an antidepressant, so wondered if it would be a good adjunct treatment for weight gain associated with psychotropic drugs?
Posted by ed_uk on February 4, 2006, at 13:17:32
In reply to What about Meridia? » ed_uk, posted by Racer on February 4, 2006, at 12:20:32
Hi Racie
Sibutramine (Meridia, Reductil) cannot be combined with MAOIs as the serotonin syndrome would theoretically occur - I thought I'd better mention this first because Tom's thread is about Marplan!
Sibutramine is an SSNRI. It is also a 'weak' dopamine reuptake inhibitor. In the treatment of obesity, the usual starting dose is one 10mg capsule in the morning. The dose can be increased to 15mg/day if necessary. In the US but not the UK, sibutramine is also available as 5mg capsules, which can be prescribed to patients who suffer side effects at higher doses.
>I know it was originally created as an antidepressant.........
That's right. Unexpectedly, it didn't seem to be effective in the initial trials. As a result, the development of sibutramine as an antidepressant was discontinued. I do think sibutramine has potential as an antidepressant though. On the other hand, worsening of depression and suicidal ideation have been reported as side effects of sibutramine - but this is also the case with conventional antidepressants.
>.........adjunct treatment for weight gain associated with psychotropic drugs?
Sibutramine inhibits the reuptake of serotonin and NE. Combining it with other SRIs might be problematic. Combining sibutramine with Effexor or Cymbalta would be illogical.
Sibutramine might be an effective treatment for weight gain associated with olanzapine (Zyprexa).....
Sibutramine might also be useful in combination with other APs or mirtazapine (Remeron, Zispin).
As a potential antidepressant, sibutramine does have the potential to induce mania, mixed states or rapid cycling in patients suffering from bipolar disorder.
Ed xx
Posted by Tom Twilight on February 5, 2006, at 5:10:55
In reply to Re: MAOI Weight Gain-Does anything help? » Tom Twilight, posted by ed_uk on February 4, 2006, at 11:55:26
> You could ask your GP to prescribe orlistat (Xenical)
Thanks for advise all
Unfortunatly never of those solutions sounds ideal.
Orlistat can interefear with fat solubabl vitamin absorbtion.I think I need all the Vitamins I can get!
Despite the fact that Sibutramine looks good on paper, I haven't read of a single person responding well to it in reallity.
Most people find it makes them jittery, I believe
Posted by ed_uk on February 5, 2006, at 17:04:43
In reply to Thanks for Advise Everyone!-Sibutramine, posted by Tom Twilight on February 5, 2006, at 5:10:55
Hi Tom
The fat soluble vitamins are A, D, E and K. Vitamin D in paticular should be supplemented when you're taking Xenical.
Ed
Posted by cecilia on February 5, 2006, at 23:15:56
In reply to Re: Thanks for Advise Everyone!-Sibutramine » Tom Twilight, posted by ed_uk on February 5, 2006, at 17:04:43
Xenical is supposed to be available over the counter soon in the U.S. I bet the Depends manufacturers were pushing hard for this!
Posted by River1924 on February 8, 2006, at 1:01:44
In reply to Thanks for Advise Everyone!-Sibutramine, posted by Tom Twilight on February 5, 2006, at 5:10:55
It helped with my depression and the sleepiness which is worsened by seasonal affective disorder but, I agree, it does make one very nervous. Awake. And nervous.
And as Ed said, I wouldn't even try to combine it with an MAOI. I've combined about everything but even I would draw the line there. (Although... some doctors are willing to combine more recent antidepressants with an MAOI.)
PS: Do you think the 'obesity epidemic' has anything to do with all the drugs we take in the USA? (I'd weigh 7000 lbs if I took seroquel or paxil for very long.)
> Despite the fact that Sibutramine looks good on paper, I haven't read of a single person responding well to it in reallity.
>
> Most people find it makes them jittery, I believe
Posted by ed_uk on February 8, 2006, at 12:49:38
In reply to Sibutramine (ps: obesity), posted by River1924 on February 8, 2006, at 1:01:44
Hi R
>Do you think the 'obesity epidemic' has anything to do with all the drugs we take in the USA?
Yep!
Ed
This is the end of the thread.
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