![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Kenya on April 7, 2009, at 15:25:34
Hi!
So, my pdoc just prescribed this. I've read so many horror stories about weight gain and metabolism slowing just from googling it today. I really don't think I should take it.
My pdoc has met with me twice for about 10 minutes each time and decided to tell me that he thinks I'm bipolar. For one, I totally disagree, two - why the heck would he tell me that (I was a little offended), and three - I have worked really hard to lose a good deal of weight.
Also, my dad (an olympic swimmer/diver - always an athlete) has had heart problems his whole life. I'm afraid with the heart disease history in my family and my own weight issues, this medication might hurt more than help. Does anyone have any thoughts about this?
~ Kenya
Posted by yxibow on April 7, 2009, at 15:52:30
In reply to Seroquel XR 200, posted by Kenya on April 7, 2009, at 15:25:34
> Hi!
Welcome.
> So, my pdoc just prescribed this. I've read so many horror stories about weight gain and metabolism slowing just from googling it today. I really don't think I should take it.
>
> My pdoc has met with me twice for about 10 minutes each time and decided to tell me that he thinks I'm bipolar.
For one, I totally disagree,Perfectly entitled
two - why the heck would he tell me that (I was a little offended),
Well, you did go to a doctor for a diagnosis -- that is an opinon ?
I mean he has to observe you and make some learned conclusion -- if you think that the session was too short, well you can go to a doctor that does 45 minute sessions but not a lot of HMOs/etc will pay for that, that might have to be out of pocket. You're entitled to that, its a second opinion, or a third opinion.You're also entitled not to have a doctor, but I wouldn't suggest it if you observe something that concerns you.
And, yes, sometimes there is a feeling of offense, but there are a lot of diagnoses out there -- I think the offense comes from the stigma of mental illness, or maybe the offense comes from "Why would I be [x] illness....it doesn't seem like me."and three - I have worked really hard to lose a good deal of weight.
That I can understand, taking Seroquel off-label myself.
> Also, my dad (an olympic swimmer/diver - always an athlete) has had heart problems his whole life. I'm afraid with the heart disease history in my family and my own weight issues, this medication might hurt more than help. Does anyone have any thoughts about this?
If you don't have heart disease and you're fairly young at the moment, its not a -known present- risk factor, its just something to consider about.The weight issues can be maintained better if you start off at the first time of taking a medication with such a liability by a concerted effort of a weight plan (limiting calories to only a certain amount) and plenty of exercise.
Also, did you discuss other medications such as Lamictal before considering or adding Seroquel ?
There are other atypical APs... Seroquel carries a risk burden like several of weight factors but it carries much lower side effects otherwise (EPS and tardive issues).-- best wishes
-- Jay
Posted by Kenya on April 7, 2009, at 16:12:06
In reply to Re: Seroquel XR 200 » Kenya, posted by yxibow on April 7, 2009, at 15:52:30
Hi Jay,
Just to rephrase, I wasn't offended by a diagnosis of bipolar. I was offended that he seemed to make a decision to label me without having much information about me. I am seeing him to begin with because of PTSD and sleeping problems from a recent traumatic event. I didn't expect a whole new diagnosis. I probably should have mentioned that to begin with, my apologies.
Thank you for your input. I definitely will consider what you said about Seroquel having less side effects than other treatments. The diet/exercise plan would be easy for me because I already work out about 5 or 6 days a week.. I might just need to add some more cardio for a while.
Do you know if the weight gain effect fades as you continue taking it? Or does it stay relatively consistent?
- Kenya
Posted by Phillipa on April 7, 2009, at 21:27:21
In reply to Re: Seroquel XR 200, posted by Kenya on April 7, 2009, at 16:12:06
Happens to often. Can you get a second opinion?. Love Phillipa
Posted by desolationrower on April 8, 2009, at 7:57:01
In reply to Re: Seroquel XR 200, posted by Kenya on April 7, 2009, at 16:12:06
> Hi Jay,
>
> Just to rephrase, I wasn't offended by a diagnosis of bipolar. I was offended that he seemed to make a decision to label me without having much information about me.i don't know how good your doctor is, but (given that he seems to be working in with time constraints b/c of insurance which i doubt he likes either) telling you a diagnosis isn't necessarily a bad thing. i've had doctors who won't give diagnosis or say much at all about what they are thinking other than tell me what med they are prescribing. knowing what he's thinking can be useful.
>I am seeing him to begin with because of PTSD and sleeping problems from a recent traumatic event. I didn't expect a whole new diagnosis. I probably should have mentioned that to begin with, my apologies.
most drug for sleep/ptsd will cause weight gain to some extent (since the point is to slow down your brain, and they aren't targeted perfectly). much of the problem with APs is you don't get satiety signal (not the whole problem, but wild guess is more than 50%) so its very easy to overeat. otoh, the weight gain seems worse the closer to a healthy weight you are.
> Thank you for your input. I definitely will consider what you said about Seroquel having less side effects than other treatments. The diet/exercise plan would be easy for me because I already work out about 5 or 6 days a week.. I might just need to add some more cardio for a while.
>
> Do you know if the weight gain effect fades as you continue taking it? Or does it stay relatively consistent?
>
> - Kenyasince they usually cause weight gain, and weight gain inhibits weight gain through multiple mechanisms (in the short term, becoming obese and diabetic f*cks with metabolism), it tends to slow down.
personally i don't think the antihistamine part is going to help at all with the PTSD, but will make weight gain worse.
i'm not sure if you've tried other drugs. if maintaining weight is already something you have to work hard at to do, quetiepine doesn't seem like a good drug to start on.
-d/r
Posted by yxibow on April 9, 2009, at 2:12:21
In reply to Re: Seroquel XR 200, posted by Kenya on April 7, 2009, at 16:12:06
> Hi Jay,
>
> Just to rephrase, I wasn't offended by a diagnosis of bipolar. I was offended that he seemed to make a decision to label me without having much information about me. I am seeing him to begin with because of PTSD and sleeping problems from a recent traumatic event. I didn't expect a whole new diagnosis. I probably should have mentioned that to begin with, my apologies.I understand.
> Thank you for your input. I definitely will consider what you said about Seroquel having less side effects than other treatments. The diet/exercise plan would be easy for me because I already work out about 5 or 6 days a week.. I might just need to add some more cardio for a while.If you have an active lifestyle like that, and you can stand the possibility of a trade off of possibly gaining -some- weight but less than others who aren't active like that, I don't see why a medication that has more benefits than risks should be a problem.
> Do you know if the weight gain effect fades as you continue taking it? Or does it stay relatively consistent?
Unfortunately I think for most all people, the atypicals that are prone to weight gain stay consistent through treatment.
Geodon and possibly Abilify have fair to neutral weight gain. However they have more EPS for some people, specifically akathisia (the feeling of having to move, a squirminess that is NOT anxiety)
Geodon has been extensively analyzed twice for heart (QTc interval rate) anomalies and is generally considered to have passed that test. Still it does carry a very low (1/4000) -possible- risk of torsades de pointes.
On the other hand, so does the still marketed typical antipsychotic Mellaril, more frequently.
Seroquel and Zyprexa probably have the most weight gain, Risperdal has some but has more long term effects liability.
-- Jay
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.