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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 thinkingitover on January 22, 2010, at 20:33:06
I have Gad, and the SSRIs fatten me up like a turkey on Thanksgiving, even at low doses. I am fed up with it. I've been on the SSRI rollercoaster for 5 years.... started at 146lsb, now a lardy 220...
I've finally been able wean down over the years as to where I am on low doses of SSRIS...
1) What is good for GAD that isn't serotogenic and "fattening"?
2) Of my med combo below, what else could be the "fat" culprit?
1) Prozac 10 MGS- huge step for me as I was once on high doses of SSRIS but haven't been for 2 years now. Weight won't BUDGE still
2) Klonopin .75 MG
3) Topamax 50 MG (funny this was supposed to help with the weight... no dice)I am seeing a new psych doc soon and want to make it very clear that this has been a problem that I want him to monitor and actually take seriously (you know how some PDOCS shrug it off)
Posted by Phillipa on January 22, 2010, at 20:37:13
In reply to Whats good for GAD- no ssris!, posted by thinkingitover on January 22, 2010, at 20:33:06
Very low dose ad and keep the benzo as not fattening. Phillipa
Posted by thinkingitover on January 22, 2010, at 20:40:30
In reply to Re: Whats good for GAD- no ssris! » thinkingitover, posted by Phillipa on January 22, 2010, at 20:37:13
> Very low dose ad and keep the benzo as not fattening. Phillipa
Thanks Phillipa but most ADs are serotogenic... hence the weight gain probs... Trying to look outside the box at other options.
Thanks for your help though
Posted by rjlockhart04-08 on January 23, 2010, at 0:17:14
In reply to Whats good for GAD- no ssris!, posted by thinkingitover on January 22, 2010, at 20:33:06
Lamictal, Xanax XR, Buspar
Posted by desolationrower on January 24, 2010, at 19:08:09
In reply to Whats good for GAD- no ssris!, posted by thinkingitover on January 22, 2010, at 20:33:06
bupropion would help lose weight. most doctors think its 'bad for anxiety' but see http://www.medscape.com/viewarticle/569752
and
Background: A common clinical belief is that more sedating and/or serotonin-selective antidepressants are preferred for depressed patients with symptoms of anxiety compared with more activating and/or catecholamine-selective antidepressants. The purpose of this study was to determine whether higher baseline anxiety is associated with different antidepressant responses to bupropion sustained release (SR) or sertraline. Methods: A retrospective data analysis was conducted using pooled data from two identical 8-week, randomized, double-blind, placebo-controlled multicenter studies of bupropion SR (n=234), sertraline (n=225), and placebo (n=233) in adult outpatients with recurrent, major depressive disorder. Anxiety symptoms were measured using the 14-item Hamilton Anxiety Rating Scale scores. Results: Baseline anxiety levels were not related to antidepressant response to treatment with either bupropion SR or sertraline, nor did they differentiate between responders to bupropion SR and responders to sertraline. Conclusions: Baseline anxiety levels do not appear to be a basis for selecting between bupropion SR and sertraline in the treatment of outpatients with major depressive disorder.
probably more helpful if your anxiety is of the 'start to panic' variety, not the ruminative sort
-d/r
Posted by Phillipa on January 24, 2010, at 19:55:34
In reply to Re: Whats good for GAD- no ssris!, posted by desolationrower on January 24, 2010, at 19:08:09
Hi d/r miss you good to see you here I'm ruminative Gad what would be good for me. Thanks Phillipa
Posted by Tony P on January 30, 2010, at 19:12:07
In reply to Whats good for GAD- no ssris!, posted by thinkingitover on January 22, 2010, at 20:33:06
Consider Cymbalta - it is mostly NE stimulating, with only a small SSRI component. It's said to be weight-gain neutral. I've found it so: I gained 50 lb. on Remeron; I haven't taken much off yet, but at least I'm not gaining any more. It's the best single med for GAD + depression that I've tried (Effexor made me worse). BTW, I am also taking Klonopin.
Adjuncts may also help - Buspar, Modafinil (Provigil, Alertec).
Wellbutrin was very effective but had too many S/E for me - anxiety, insomnia, hypomania. I also _gained_ weight on it (!), but only because my depression had left me undernourished, and suddenly I found I was enjoying food again! YMMV, as usual.
Posted by Phillipa on January 30, 2010, at 20:57:49
In reply to Re: Whats good for GAD- no ssris! » thinkingitover, posted by Tony P on January 30, 2010, at 19:12:07
So I'm not the only one that wellbutrin and not bipolar caused me to behave as if hypomanic? Also took cymbalta with benzo and don't think it help Gad but great for back pain and other pains. No weight gain. Phillipa
Posted by desolationrower on February 2, 2010, at 3:36:54
In reply to Re: Whats good for GAD- no ssris! » desolationrower, posted by Phillipa on January 24, 2010, at 19:55:34
> Hi d/r miss you good to see you here I'm ruminative Gad what would be good for me. Thanks Phillipa
hey. i think the best thing you could have would be a big project to put your energy into. or nardil.
-d/r
Posted by Tony P on February 2, 2010, at 15:52:35
In reply to Re: Whats good for GAD- no ssris! » Tony P, posted by Phillipa on January 30, 2010, at 20:57:49
> So I'm not the only one that wellbutrin and not bipolar caused me to behave as if hypomanic? Also took cymbalta with benzo and don't think it help Gad but great for back pain and other pains. No weight gain. Phillipa
Absolutely, borderline manic even. I thought I was just feeling good until my wife confronted me -- the story is amusing now, although not at the time!
She mentioned a family dinner when I was holding forth like an anthropology PhD (which I ain't) on how you tell the different ethnic groups of Central Europe apart by the shape of their heads (!) Then my daughter came in, and my wife asked her if Dad had been behaving strangely. Without further prompting my daughter said, "Yeah, Dad, you remember that dinner when you were telling us how to tell Serbs from Croatians by ...". One person I could have ignored, but that was pretty conclusive!
This is the end of the thread.
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