anti-depressants and weight gain

[AGC]

I have been on Celexa for 8 months for anxiety, depression, and stress. I am closely monitored by a psychiatrist and my long term therapist. I benefit from the control and peace that Celexa gives me but I've gained 20 lbs.! My psychiatrist wanted me to try Weight Watchers but I havent. I did go to a great registered dietician at my Dr.'s office and she had a great plan but I didn't stick with it. For the first time in my life I havent been able to lose weight by shear will and hard work. Especially before a big family event which came and went this summer with me in my size 18s...It feels like I have no control over my eating. (Also, I sweat PROFUSELY.) I'm 35, 5'8" and weigh close to 180 now. The despair I feel over the weight gain almost overshadows the benefits of the medication. One thing is for sure, it makes me a calmer,more centered, less hysterical mother to my 2 small sons. My life as a child would have been totally different if my mom had been on a medication. Prozac has benefitted her enormously in the past 5 yrs. She credits it for saving her life. Her mother was also on Prozac before her death. Both gained 20-30 lbs.
Has anyone out there had similar experiences? I love pasta- a seratonin releasing food (to my limited understanding). Cravings relate in here somewhere.
Thanks! Amy

[BevP]

Different antidepressants work differently for different people. Try asking your psychiatrist if you should try another antidepressant. If not, just weigh the choices (bad pun, I know) of trying more dieting and exercise or going off the meds (and diet and exercise).

Perhaps not what you wanted to hear but that's just how those meds are and sometimes we just have to decide if the side effects are worth the mood effects.

[jenniferharris1]

Yes, that is a bad side effect. Have you tried Zoloft? My brother-in-law was on Paxil for test anxiety, and he gained 15-20 pounds; he was then switched to Zoloft and found that he had the same benefits without the weight gain. Ask your psychiatrist for other options. I wish you well.

[NydiaC]

Really consider Weight Watchers. I, along with others on this board I'm sure, highly recommend it. Not only is it easy, but you get a whole lot of emotional support as well. If you do a search on Weight Watchers, you'll come up with a ton of matches. Here is one in particular that you might be interested in:

http://www.cookinglight.com/vbb/showthread.php?s=&threadid=9351&highlight=weight+watchers

P.S. I don't work for them, but I know the program works.

[RobinC]

You are not alone. I have experienced the same weight gain affect with Prozac. My Dr. told me that in some people Prozac will act as an appetite stimulant. We discussed the option of Meridia (the appetite depressant), but because Meridia is so close to Prozac, you cannot take the 2 together. My Dr. also told me that there is some indication that taking Meridia will offer some of the same benefits of Prozac. I decided that my mental health is more important than my weight right now. I've gone to see a registered dietician and we came up with some food and behavior goals. A very important step for me is writing down/journaling EVERYTHING that I eat. I also note how I am feeling when I eat. Slowly I am changing my eating habits and becoming much more aware of weight-destructive behaviors.

What has been the most helpful for me is a support system. Many people have found this with Weight Watchers (I wasn't too impressed with the leader and the group when I tried it, but that is only my experience from years ago), I have a work/weight loss mentor who has helped me more than I can say.

Good Luck!

[Margie]

Different medications affect different people differently. My sister had to be taken off Prozxac because she lost so much weight. When I took it during a difficult time in my life about 6 years ago, it did not have that effect on me.

Weight Watchers is an answer, if you can stick with it. Two people in my office are on it now. They are not doing as well as they could because it seems like they have the attitude, I'm on Wieght Watchers so I should be losing weight. Unfortunately, it is not a magic solution, you have to work at it and follow their recommendations.

Your mental health is the most important and as you are more stabilized, I'm sure that you will be able to retake control of this part of your life also. Grow your confidence from the gains that you do make...taking good care of your kids is the most important. The take care of yourself in little ways...nice hand lotions, a good, flattering hair cut and the rest will fall into place.

[Ralph]

Here's my medical opinion: Decreased appetite, weight loss, and/or anorexia are listed as side effects for all of the meds you've listed above; none lists weight gain. That's not to say it doesn't happen - the listed side effects are just those that show up with statistical significance in controlled studies.

I suspect much of the weight gain is related to improved mood. Weight loss, anorexia, and the like are all common symptoms of depression, anxiety disorders, and stress. But again, some people go the opposite direction! As you've been on these meds, your mood/outlook/frame of mind improve, thus stimulating appetite.

[AGC]

Thanks, everyone for your support. I would love to do WW but I do not feel that I can take the time once a week away from my family. We are so busy and don't even participate in organized sports yet!! I've thought about doing it online but I'm not sure I'd stick with it.

Ralph: Thanks for the info. I was thinking this could be somatic or related to some other emotional issue (my therapist's opinion). The overeating cant be just because i'm happy now because I'm eating compulsively (ie: 3 helpings of (lite) chili-mac, 1 c. spinach, 1/4 cantaloupe, 1 c. 1% milk, 1 fudgesicle, and 5 twizzlers just in the past hour.) I've always been an overeater but I've now become out of control!! ps. I visited Naperville 21 yrs. ago, lovely place.

After I read everyone's replies I called WW and scheduled an info session for my workplace. They will do a minimum of 17 people, for 10 wks. at $130.00 at your workplace. The director of my hospital approved it so now we are waiting for WW to find a leader whose sched. fits our sched. I'm very excited about this. I'll post more when I see how it goes!

Thanks again everyone! Amy

[JHolcomb]

I've been on Paxil for around 5 years now for extreme anxiety caused by an obsessive desire to do everything perfectly (or so my therapist thinks :) ). I managed to gain a lot of weight before I went on it because when I'm nervous I eat everything in sight. Now my panic/anxiety/whatever is pretty well under control thanks in large part to the Paxil, and I've started losing weight. I know that people who get depressed or anxious react to food in one of two ways-ignore it altogether or eat to fill the void. If you lost your appetite before it is logical to think that you would have regained it once your condition was under control and possibly would have gained weight. I don't know that it directly influences weight gain, though. My sister was on Prozac, though, and stopped taking it because she gained weight (hmmm...an extra 10 lbs or insanity...I'll take the extra 10 lbs). My mom's on Celexa and has gained weight. but she's on many, many drugs (she has MS) and I don't think that's what's causing her weight gain, honestly. On a side note, I too, wish she'd been on antidepressants when we were little-she had scary horrible post partum depression-one reason I'm afraid to have kids. Anyhoo...

Anyway, I'd try Weight Watchers. I know many people that have had success with it. I'm glad you're feeling better emotionally-it's wonderful that you've found something that works for you in that department. I'm sure you'll have good luck with the weight loss, too.

[emilycat]

Amy,

Just thought I'd add my input to your already great responses --
I've taken Luvox for a year and a half, and because of some ED issues, I was extremely concerned about weight gain -- I never gained a pound because of the medication. My psychologist at the time assured me that any weight gain associated with SSRI's was due to increased craving for carbs and sweets, though, and considering my situation, it makes quite a bit of sense that weight gain didn't affect me. I do agree with everyone else, though, and your mental health is absolutely most important. Everything else will follow :)

Ralph, I do have a bit of a question for you -- you mentioned that anorexia was a symptom of depression. Hm. I know you're the one with the medical degree, but I must beg to differ. Depression is a symptom of anorexia, which is a disease in itself. Did I misunderstand you? Depression and anorexia certainly go hand in hand with one another -- most anorexics exhibit symptoms of depression, but I don't understand how a person with depression can develop anorexia simply by virtue of being depressed. Anorexia is far too complex to simply be a symptom.

Anyway, sorry to change the subject. :D

[BlueMoose]

As a symptom, I believe the term "anorexia" simply refers to a loss of appetite.

[karen w]

Emilycat,
I think Ralph was just using the term "anorexia" as simply a medical term which is defined as diminished appetite and not the entity/disease anorexia nervosa. He can correct me if I am wrong, but I think this may clear up your confusion.

Karen W.

[slknight]

Something you might want to ask your therapist about is Effexor. I have been on it for about six months due to depression following a miscarriage. I was told that many anti-depressants can cause weight gain (whether as a side effect or a side effect of feeling better), and I specifically said that that would send me over the edge. I was already feeling horrible from having gained pregnancy weight and my self-esteem related to my weight was at rock bottom. I said that I absolutely did not want to go on meds if I would gain any weight. She said that Effexor is the least likely to cause weight gain. I have been very content on it and have actually now lost 17 pounds on weight watchers. I know that different meds affect people differently, but you might want to look into it. (BTW, one of my sisters is on Zoloft for depression, and the other one is on Paxil for anxiety. Geez. My whole family is nuts!)

-Susan

[KValley]

I'd like to add a note regarding exercise and its benefits in treating depression. Several recent studies have shown that regular exercise- something akin to a minimum of a 30 minute walk 3x/week- have had significant effects in alleviating depression, or the symptoms thereof. Its affects body chemistry- releasing endorphins- as well as giving a sufferer of depression a greater sense of control, achievement, sense of purpose. Needless to say, it is essential in any plan to lose weight.

Exercise is not a replacement for medication, but I can't see any responsible weight loss or depression management plan without it. Amy, I know your time is so over-committed, but is it possible to take the kids out a few times a week for a walk? Ralph, maybe you could weigh in here with a professional opinion...

My 2 cents,

Julie

[Ralph]

Originally posted by karen w
Emilycat,
"anorexia" is defined as diminished appetite and not the entity/disease anorexia nervosa.
Karen W.

EXACTLY, Karen. And you, too, Chrisi.

Medical terminology can often be confusing. Quick tangent - funny story along these lines. My residency program director (a single mom) often brought her 10-year-old son to our journal clubs, which were held at local restaurants. During one discussion, he leaned over to her and said, "Mom, what language are they speaking?" :D :D

[AmyS]

Amy--
Thought I too would add my two cents here......
I recently started on Wellbutrin for some depressive sxs and anxiety--they had been persistant for a long time and I finally decided to do something about it. I requested to try Wellbutrin first because I knew that it could have the weight loss side effect. I have only been on the recommended dosage for just about 2 weeks now and I have lost 5 pounds....now, it could be the meds or it could just be that I am feeling a little bit more motivated and energized, and I don't get bored and eat. I have been more active and able to keep myself focused....So I believe that the input you have received so far is pretty accurate, it all depends on your own reactions to the meds...I have had plenty of clients that have gone through several different medications until they found one where the benefits outweighed the side effects....I wish you the best!
-another Amy

[emilycat]

Ah, I see. I'd never heard it used as such before, but now I know. Thanks guys! :)

[AGC]

I've printed this thread and will take it to my psychiatrist (I only see her for med. maintenance; I see my therapist weekly) when I go in Aug. I am encouraged by all of you that the fact is, the med.s vary and I just need to try. This is something I've discussed with my Psych. but not lately (she takes a 5-wk. vacation each summer).

JHolcomb: I can relate to your story both as a daughter and as a mother. I hope the recent story out of Texas brings the whole issue of post-partum depression to everyone's attention (post-partum psychosis is not specifically what I'm talking about here but is, I think, an extreme of post-partum depression and not common). It is common but treatable. I experienced it with my 1st son, not my second. I wonder if the fact that depression runs rampant among the women in my family has anything to do with my postpartum depression; my guess is that it does. I did survive it with the support of my excellent therapist, a 100% angel of a husband, and going back to work (helped with the lonliness and anxiety to an extent-just my experience). Ironically, my Mom has been a tremendous support and friend because she relates to my struggles as a mother, and remember, she too is well-medicated. I actually do pretty well most of the time with my brilliant and spirited little boys (6 and 3). So, if you do decide to have children, I'm sure you'll find strength you never dreamt you had. All of the character-building things you've experienced will serve to make you a super Mom. And, p.s., I also live in Raleigh! kindredly, Amy

[AmyMcP]

I went on CELEXA last year and found a mild weight gain. Then I learned that the dosage I was taking was not therapeutic, so I was placed on a low dosage of PAXIL. I noticed a difference in my mood immediately! Wonderful, but the weight gain was not. Two years ago, I joined Weight Watchers and had success losing the freshman fifteen and a little more. But the anti-depressant put it right back on. UNFORTUNATELY, most medications have this side effect. They basically slow down your metabolism, so it doesn't matter that you diet or watch what you eat...your body will hold on to everything. I am not saying eat whatever you want...still count calories and fat and exercise.

I can attest that once off the medication, the weight is slowly coming off.

HINT: my sister-in-law works for a pharm. company and she suggested to take a Mylanta of TUMS after eating to help w/ digestion. And to drink a lot of water or Crystal Light.
I know EXACTLY how you feel. Hang in there! We can lose and sweat together!:)

[McSix]

My husband has been on Celexa for a year now. Before he was diagnosed with depression he had lost 25 pounds and was miswerable. Since the Celexa life is very balanced and he's back to the guy I married. He has gained 20 pounds--more than he wanted to gain, but he's himself again. He's working on exercising more and has increased that tremendously. His doctor told him that the weight gain was a common side effect.

[AD]

My problem is just the opposite. My weight is critically below average. (I'm a 5'3" age 19 male and weigh 70 pounds.) Anyway, I am on Zoloft which has helped me a lot during the past year. It actually increased my appetite, but not enough to gain weight, just to maintain. I still work with doctors and dietitians with my weight and other problems, and I am trying to gain weight. Most of the problem is digestive discomfort. I especially enjoy CL's more calorie-dense recipes.

[foodie]

The sweating you are experiencing is caused by the Celexa. For some people this is enough of a problem that they must dicontinue the medication.

The antidepressants least likely to cause weight gain are Wellbutrin and Effexor. Some people will actually lose weight on them, or at least not gain any more.

Good luck.

[AmyO26]

This is my first post (I've been "lurking" for awhile)! Anyway, to add to the rest of the posts, sometimes antidepressants affect people differently. I have been on a low dose of paxil for the past several years, and I have experienced a tremendous improvement in mood as well as a slight weight loss (probably because I would eat when depressed, anxious, etc).
Anyway, in the August issue of Self, it said that about 20% of women on SSRI meds (prozac, zoloft, paxil) reported a weight gain, and that other antidepressants (such as wellbutrin) are much less likely to cause weight gain. Sometimes you have to try several meds before you find one just right for you (I was initially prescribed zoloft but had to switch due to terrible headaches and heavy sweating!) Talk to your psychiatrist when you go in August, and she will be able to give you a lot more info. and options.
Good luck and good health to you!
Yet another Amy!