![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 15 to 39 of 39. Go back in thread:
Posted by Adam on August 12, 1999, at 11:38:04
In reply to Re: weight gain/pharmaceutical research, posted by Elizabeth on August 11, 1999, at 13:40:44
I took Zoloft for about two years, and gained about 25-30lbs. Before Zoloft, I ate like a monster and was as thin as a
rail. One thing depression didn't seem to affect was my love of food. I've found since then that it was hard to get
rid of the weight (though I have lost most of it, with discipline). Since then I tried another drug, Remeron, which
again made me gain some weight, and again, it took some discipline and exercise on my part to keep that under control.
I've since stopped the Remeron (see the Selegiline posts above!), and lost like five pounds without even trying.Anyway, I think the SSRI/weight gain connection is a real one, despite what some studies might say. "Anecdotal"
information certainly can't stand up to intense scientific scrutiny, simply because there are no controls, but it cannot
regarded as completely spurious either. And there's plenty of anecdotal info. out there to support the connection.
Every doctor I have spoken with (and that's been a bunch) has had patients who gained significant weight on SSRIs. One
can always argue that this is not a side effect of the drug but a result of improved appetite following a depressive
episode. I doubt it's that simple. In my experience, I ate the same with or without Zoloft, and gained a huge amount of
weight in a very short amount of time as soon as I started taking it. I've heard similar complaints from other people,
and most of my doctors considered the weight gain a bona-fide side effect of the drug.If you consider how much lower the reported incidence of, say, sexual difficulties are compared to the "anecdotal"
rates (better than 50% from what I've read, and every doctor I've spoken with thinks this is the reality), this gives one
some perspective on controlled studies of side-effects.
>
> Wellbutrin [Glaxo Wellcome] isn't really a post-SSRI - it was first approved in '85 (then "disapproved" for a few years because of the seizure thingie).
>
> But anyway, there was a study published just this month on weight gain with an SSRI (Prozac).
>
> http://ajp.psychiatryonline.org/cgi/content/full/156/8/1170
>
> (You're not going to like their conclusions, though.)
>
> Probably part of the reason that they haven't looked into this more is that it's a long-term side effect and long-term studies are hard to do.
Posted by Annie McNeil on August 12, 1999, at 13:14:20
In reply to Re: weight gain/pharmaceutical research, posted by Adam on August 12, 1999, at 11:38:04
Hi Adam,
How long were you off Zoloft before the weight started coming off? I've heard that the weight loss is sometimes delayed after cessation of the drug and when it does come off it's a slow process over several months. Was this true for you, or did you start to lose weight immediately? Also, did the weight gain start in the beginning of treatment or after long term use?
Thanks,
Annie
Posted by Adam on August 12, 1999, at 17:06:43
In reply to Re: weight gain/pharmaceutical -? For Adam, posted by Annie McNeil on August 12, 1999, at 13:14:20
It took a while before the weight came off, and I pretty much had to exercise and watch what I ate to make this happen.
It makes sense, really. You put on fat cells, and you've got them for life. It's so much easier to put on weight than
to get rid of it for that very reason. They remain, and essentially say "feed me" as long as they're around. The fact
that a drug probably triggered they're proliferation will not change this unfortunate scenerio, I don't think. However,
I am guessing that there are metabolic changes that occur as well, so even without trying, I can lose a little weight as
soon as the drug is gone. But it has taken some work to get close to where I was, and, well, that annoys the crap out
of me now. I was a very fit individual. To actually become a little flabby in such a short span of time was a real shock
to friends and family who hadn't seen me in a while.As far as how long it took to gain the weight, well, it was progressive but I noticed it in like a month. I put on like
20 lbs., if not more, in less than six months, and then kind of plateaued. The weird thing was, I really didn't care
at the time. I have a number of complaints about Zoloft. I never felt like it did much for depression, and it made me
kind of complacent, apathetic perhaps, and, of course, sex was just frustrating. I won't rip on SSRIs too much, because
I know they have helped many, many people, but for me, the cumulative side effects weren't worth what I was getting out
of it. Well, OK, I will rip on SSRIs a bit. I guess what I really don't like is the fact that they are touted as being
so "clean" or side-effect free. They're not really either. I'm pretty skeptical of what the medical community (their
studies being funded largely by the industrial titans that produce these drugs) has to say about SSRIs supposed safety
and efficacy. What I see in the literature seems out of line with what I'm observing in real life.I'm not arguing that
they're ineffective. But miracle drugs they ain't, IMO.> Hi Adam,
>
> How long were you off Zoloft before the weight started coming off? I've heard that the weight loss is sometimes delayed after cessation of the drug and when it does come off it's a slow process over several months. Was this true for you, or did you start to lose weight immediately? Also, did the weight gain start in the beginning of treatment or after long term use?
>
> Thanks,
> Annie
Posted by Elizabeth on August 13, 1999, at 0:28:20
In reply to Re: weight gain/pharmaceutical research, posted by Annie McNeil on August 12, 1999, at 0:26:28
The trouble with the data from clinical trials intended to establish efficacy is I don't think they specifically monitor weight the way that the study published in AJP did. People may not spontaneously report weight gain, especially in short trials.
I don't blame you guys for not trusting Eli Lilly (does *anybody* trust them? I wonder if they realize just how untrusted they are? ), but I know the work of some of the authors of this paper and don't believe them to be puppets of the industry. No doubt sometime I will be accepting a grant from a pharmaceutical company to study one of their products; I don't have any intention of doing so if it's conditional on getting the results they want.
Someone asked whether some SSRIs are worse than others. I think the answer may be yes; it seems to me that Paxil is the worst.
People do tend to gain weight in the long run, particularly if their mood is not stable. People tend to gain weight when they recover from depression. I'm therefore suspicious even of fairly frequent reports by doctors or patients describing antidepressant-"induced" weight gain. (Kind of like reports that some therapy worked when clinical trials support the notion that the therapy is no better than a placebo.)
Posted by Bruce on August 13, 1999, at 9:07:00
In reply to Re: Increasing Prozac dosage & weight gain, posted by Leslie on August 9, 1999, at 13:03:13
> >I agree. It seems to be a very prevelant, but kind of "hidden" problem. What really annoys me is that both a friend and my sister are on Prozac as well and they haven't gained weight. I know neither of them really think my weight gain is due to Prozac although I've told them about how many people seem to have the same problem. My sister used to have a weight problem while I never did. I was always more on the too thin side.She keeps trying to get me to go on the Atkins diet, which I tried for a month w/ no success. BTW - My increase to 40mg of Prozac has seemed to make a difference in my energy level - I no longer have to take a nap in the afternoon and I'm back to my "normal" night-person type schedule. My appetite hasn't changed (maybe I'm a bit less hungry)but I never had a problem w/ cravings/overeating anyway.
>
> I wish someone (i.e. company) would do research and find out why these meds cause weight gain without eating more food. Then maybe there would be a way for us to lose the weight. I've been off Prozac for ten years and cannot lose any of the 30 pounds that I gained. (I, too, was one of those skinny, skinny people before Prozac.) Now I'm on Celexa which has completely killed my appetite (I have to force myself to eat and am probably consuming less than 900 calories a day) and yet I've gained five pounds. Go figure. (And yes, I excersise regularly.)
> >
> > >
Are you sure you are consuming only 900 calories/day? If you are also exercising, and still not losing weight, AND only eating 900 cal/day, then this is a strong indicator of thyroid failure (which may be causing your depression). Have it checked out.BTW, I am a fitness buff, and having helped several people try to lose weight, I have noticed a strong tendency for the dieters to *VASTLY* underestimate their caloric intake and overstate their exercise. Just an observation in general, it may not apply to you.
All the best, Bruce
Posted by Annie on August 13, 1999, at 17:42:03
In reply to Re: weight gain/pharmaceutical research, posted by Elizabeth on August 13, 1999, at 0:28:20
>I know the work of some of the authors of this paper and don't believe them to be puppets of the industry. No doubt sometime I will be accepting a grant from a pharmaceutical company to study one of their products; I don't have any intention of doing so if it's conditional on getting the results they want.
I also know the work of some of these authors. In fact, one of them is my Pdoc. I believe 'puppets of the industry' is a little too harsh, but I think you are being naive (You should be naive Elizabeth, you are very young. The jaded, cynical view happens much too soon for some of us) if you don't realize that in the academic research world, funding makes that world go 'round. I doubt very strongly, the funding was explicitly conditional on the results, but future funding is a consideration. It is interesting to note that David Michelson(lead author) works for Lilly. Also of note are the previous studies involving Prozac in which some of the authors have been involved. All that I have read were funded by Lilly. They also had results favorable to Lilly.
Reviewing the study was like walking backward thru a maze. The study does not say there is no weight gain on Prozac. It says the weight gain on Prozac was equal to the placebo group weight gain. On Prozac 25.4% of the participants had 7% or more increase in weight. In placebo it was 26.7%. The weight gain in the Prozac group was attributed to improvement in appetite after recovery while it was poor nutrition for the unfortunate placebo group.
Their statement that "the number of fluoxetine-treated patients with a 7% or greater increase in weight never exceeded that of patients in the placebo group" loses some impact when you consider that only 15 placebo participants were able to finish the study.( It will be a great sound bite though) The results of all participants, whether they completed or not, were a little different.
Prozac- 13.2% had 7% or greater weight increase.
Placebo- 7.4% had 7% or greater weight increase.
So a greater percentage of people had better appetites than poor nutrition.
I could go on and on ripping this apart but I think you get the picture. You can make numbers mean whatever you want.
I hope you are able to refuse grants from pharmaceutical companies with agendized study proposals, Elizabeth. It would be refreshing.Annie
Posted by Adam on August 13, 1999, at 18:20:41
In reply to Re: weight gain/pharmaceutical research, posted by Annie on August 13, 1999, at 17:42:03
I never meant to suggest that the research was being conducted by "puppets of the industry". But I am a researcher also (though I do not have my PhD-I doubt that matters, really).
When in academia, some of the work I did was funded by big pharm. Now I work in little pharm/biotech, but really the biases are the same. Where the money comes from does matter.
It's that simple. Explaining why would take forever and those who understand the nature of these uneasy alliances would probably agree that it's not a simple thing to dissect.
I do not doubt the integrity of the authors as scientists. However, I would not be the least suprised if other reports came out that were independantly funded contradicting this one.
Both would have valid points. It's a complicated issue, I'm sure. I am leary of this report because I know that the source of funding can influence data (at least in how it is
interpreted when it is open to interpretation), and because it contradicts what I have seen and experienced myself in the real world. I think other people who have put on a lot of
weight in a short period of time while taking an SSRI are experiencing a legitmate side effect of the drug and should be paid attention to. The fact that this is not a universal
phenomenon, or one that might not fall outside the error bars in a particular study does not lessen my conviction. I know my body and what happened to it. None of my doctors ever
doubted what the nature of the weight gain was. It's real, it happens, and people should know about it.> >I know the work of some of the authors of this paper and don't believe them to be puppets of the industry. No doubt sometime I will be accepting a grant from a pharmaceutical company to study one of their products; I don't have any intention of doing so if it's conditional on getting the results they want.
>
> I also know the work of some of these authors. In fact, one of them is my Pdoc. I believe 'puppets of the industry' is a little too harsh, but I think you are being naive (You should be naive Elizabeth, you are very young. The jaded, cynical view happens much too soon for some of us) if you don't realize that in the academic research world, funding makes that world go 'round. I doubt very strongly, the funding was explicitly conditional on the results, but future funding is a consideration. It is interesting to note that David Michelson(lead author) works for Lilly. Also of note are the previous studies involving Prozac in which some of the authors have been involved. All that I have read were funded by Lilly. They also had results favorable to Lilly.
> Reviewing the study was like walking backward thru a maze. The study does not say there is no weight gain on Prozac. It says the weight gain on Prozac was equal to the placebo group weight gain. On Prozac 25.4% of the participants had 7% or more increase in weight. In placebo it was 26.7%. The weight gain in the Prozac group was attributed to improvement in appetite after recovery while it was poor nutrition for the unfortunate placebo group.
> Their statement that "the number of fluoxetine-treated patients with a 7% or greater increase in weight never exceeded that of patients in the placebo group" loses some impact when you consider that only 15 placebo participants were able to finish the study.( It will be a great sound bite though) The results of all participants, whether they completed or not, were a little different.
> Prozac- 13.2% had 7% or greater weight increase.
> Placebo- 7.4% had 7% or greater weight increase.
> So a greater percentage of people had better appetites than poor nutrition.
> I could go on and on ripping this apart but I think you get the picture. You can make numbers mean whatever you want.
> I hope you are able to refuse grants from pharmaceutical companies with agendized study proposals, Elizabeth. It would be refreshing.
>
> Annie
Posted by Lisa T on January 25, 2001, at 8:33:56
In reply to Re: weight gain/pharmaceutical research, posted by Adam on August 13, 1999, at 18:20:41
Hi there, I found this web site when I was searching for answers late one night, and I am relieved to hear others having very similar experiences.
I have been on prozac for two or so years and have noticed a difference in my weight and bodyshape. I have put on about 5 kgs that I cannot seem to lose no matter what I do (yes I train 5 days a week and follow a strict and very healthy diet). I certainly sleep a lot more than ever, and am very annoyed about all of this distinct lack of energy and weight gain. It's as if my body is holding on to fat and won't let it go.
I have decided to stop taking prozac and try to regain my body (I was in great shape before!) and hopefully I will lose the 5 kilos I have gradually put on.
My other half has been on zoloft for the past year and he has also gained weight.
I am not a researcher, nor am I a scientist, but I do believe that there is a correlation between raising serotonin levels and weight gain. You raise serotonin levels, you feel better, your body sleeps more, conserves more, does not expend as much nervous energy, your metabolism slows. Well, that's my speel on it anyhow.
My doctor suggested that I might increase the dosage of prozac to help raise my energy levels and thus lose weight, but I have opted to quit altogether. I do not think that increasing is the answer, it might help initially to raise energy levels and lose a bit of weight, but then I think my body will become accustomed to the drug and plateau again. And who knows, in four years, I may have packed on another 5 kgs!
Hopefully my depression will not re-emerge and I will lose the weight and get back to feeling good about myself again. Wish me luck, and I welcome any comments.
Posted by Joy on January 25, 2001, at 8:57:59
In reply to Re: weight gain/pharmaceutical research, posted by Lisa T on January 25, 2001, at 8:33:56
Hi. I always thought Prozac was much more weight neutral than Paxil or Zoloft for most people. I guess we are all different. I just wanted to say that one of my closes friends is on Prozac 11 years and she is very slim. She does not eat a whole lot andis really thin. She is on 60 mg of Prozac.I just started Prozac 3 weeks ago and feel great. I plan on staying on it, but will watch my weight from the beginning. I've read a lot of posts where people have lost some weight when they tried while on Prozac, but almost nobody could lose on Paxil or Zoloft. I hope everything works out well for you.
Joy> Hi there, I found this web site when I was searching for answers late one night, and I am relieved to hear others having very similar experiences.
>
> I have been on prozac for two or so years and have noticed a difference in my weight and bodyshape. I have put on about 5 kgs that I cannot seem to lose no matter what I do (yes I train 5 days a week and follow a strict and very healthy diet). I certainly sleep a lot more than ever, and am very annoyed about all of this distinct lack of energy and weight gain. It's as if my body is holding on to fat and won't let it go.
>
> I have decided to stop taking prozac and try to regain my body (I was in great shape before!) and hopefully I will lose the 5 kilos I have gradually put on.
>
> My other half has been on zoloft for the past year and he has also gained weight.
>
> I am not a researcher, nor am I a scientist, but I do believe that there is a correlation between raising serotonin levels and weight gain. You raise serotonin levels, you feel better, your body sleeps more, conserves more, does not expend as much nervous energy, your metabolism slows. Well, that's my speel on it anyhow.
>
> My doctor suggested that I might increase the dosage of prozac to help raise my energy levels and thus lose weight, but I have opted to quit altogether. I do not think that increasing is the answer, it might help initially to raise energy levels and lose a bit of weight, but then I think my body will become accustomed to the drug and plateau again. And who knows, in four years, I may have packed on another 5 kgs!
>
> Hopefully my depression will not re-emerge and I will lose the weight and get back to feeling good about myself again. Wish me luck, and I welcome any comments.
Posted by Noa on January 25, 2001, at 10:47:17
In reply to Re: weight gain/pharmaceutical research, posted by Joy on January 25, 2001, at 8:57:59
does anyone know of any studies looking at exercise programs to offset ssri weight gain--whether this is effective or not?
Posted by Ignatz on January 25, 2001, at 11:14:36
In reply to Re: weight gain/pharmaceutical research, posted by Noa on January 25, 2001, at 10:47:17
I haven't found any studies linking SSRIs to weight gain, much less studies on exercise for weight gain and SSRIs. The lack of research on this really cheeses me off; there's tons of anecdotal evidence, and p-docs (mine, for example) seem to be starting to take it seriously as a side effect that affects many. But, nada in the scientific lit. My own anecdotal evidence: I gained 35 lb on Zoloft (this after not gaining a pound on Pamelor plus lithium!). I've worked out 4 to 6 times a week for 5 years, watch what I eat, and have lost 15 pounds over the years. I find this puzzling and disturbing, but I prefer being sane and a little chunky to the alternative...
Posted by Noa on January 25, 2001, at 15:51:36
In reply to Re: weight gain/pharmaceutical research, posted by Ignatz on January 25, 2001, at 11:14:36
I have heard--and I don't remember where, perhaps here?--that SSRIs can only be "blamed" for an average of something like 20 pounds of extra weight (which for some peopel is a LOT, I know).
I am way more overweight than that, and although it is possible for the effexor, et al to be contributing somewhat, it would be very hard to blame my huge weight gain on that, because of the following other possible "culprits": sedentary lifestyle for about 6 years, overeating out of anxiety and depression, intense sugar cravings from insulin resistance, etc.
I just started intensive exercise, and I guess I am curious as to whether my ability to lose weight will be hindered by the effexor. I guess I'll have to wait and see.....
I will say this...the exercise has drastically reduced the carbo cravings, so I am assuming that the insulin resistance is reduced by it. I guess I should get retested (glucose tolerance test) at some point to check that out. I have read that exercise can help to control insulin resistance, but I am surprised at how quickly the carbo cravings have lessened.
Posted by Lisa T on January 25, 2001, at 17:36:29
In reply to Re: weight gain/pharmaceutical research, posted by Adam on August 13, 1999, at 18:20:41
I wonder if there is anyone out there who has increased their dosage of Prozac and has lost weight and felt better - long term that is.
Posted by Jay on January 31, 2001, at 5:41:35
In reply to Re: weight gain/pharmaceutical research, posted by Lisa T on January 25, 2001, at 8:33:56
Actually, I think there are a couple of very complex reasons why we gain weight on SSRI's. I don't think it's a "one theory" answer.
One, from the research, it seems the SSRI effect on Dopamine receptors and levels, especially over time, is very, very strong. I think this is why there is some concern about Parkinson's and SSRI's. as well as noted abnormal movements and SSRI's. I also think that doctors MAY want to start looking a putting a slow limit of length on SSRI's. This is not "anti-drug", just for long term use, possibly TCA's may want to be looked at after say a 5 or more year use of SSRI's. The TCA's do not seem to induce the abnormal movements (minus amoxapine..which is more like an anti-psychotic).
The other MAY be a "down-regulation" of serotonin receptors, although, in light of the recent evidence of new serotonin receptor growth after lengthy SSRI use, I am not so sure this is the case.
In the long run, I think weight and sex drive are things that cannot be ignored, because they both have a strong effect on our general well being.
Yes, I know, depression is very deadly of course, but after a five+ year use of an SSRI, AND, if the adverse effects are quite strong on both weight and sex drive, I think it might be wise to look at alternatives.In otherwords, SSRI's are great first-line meds, and over a period of many years can help a person put their life back together. I think the above mentioned considerations should be cause for a complete reevaluation, say even every five or so years, of the very blatent side effects.
> Hi there, I found this web site when I was searching for answers late one night, and I am relieved to hear others having very similar experiences.
>
> I have been on prozac for two or so years and have noticed a difference in my weight and bodyshape. I have put on about 5 kgs that I cannot seem to lose no matter what I do (yes I train 5 days a week and follow a strict and very healthy diet). I certainly sleep a lot more than ever, and am very annoyed about all of this distinct lack of energy and weight gain. It's as if my body is holding on to fat and won't let it go.
>
> I have decided to stop taking prozac and try to regain my body (I was in great shape before!) and hopefully I will lose the 5 kilos I have gradually put on.
>
> My other half has been on zoloft for the past year and he has also gained weight.
>
> I am not a researcher, nor am I a scientist, but I do believe that there is a correlation between raising serotonin levels and weight gain. You raise serotonin levels, you feel better, your body sleeps more, conserves more, does not expend as much nervous energy, your metabolism slows. Well, that's my speel on it anyhow.
>
> My doctor suggested that I might increase the dosage of prozac to help raise my energy levels and thus lose weight, but I have opted to quit altogether. I do not think that increasing is the answer, it might help initially to raise energy levels and lose a bit of weight, but then I think my body will become accustomed to the drug and plateau again. And who knows, in four years, I may have packed on another 5 kgs!
>
> Hopefully my depression will not re-emerge and I will lose the weight and get back to feeling good about myself again. Wish me luck, and I welcome any comments.
Posted by Ignatz on January 31, 2001, at 18:57:05
In reply to Re: weight gain/pharmaceutical research » Lisa T, posted by Jay on January 31, 2001, at 5:41:35
I'm cautious about the idea of going off of SSRIs after 5 years; this might work for some people, but it might prove dangerous for others. For example, I ended up on Zoloft after 2 nasty depressive episodes (one at age 13, one at age 27), a family history of depression, and a very partial response to treatment with a tricyclic (nortriptyline). I gained 35 pounds on Zoloft, but my p-doc has never mentioned stopping SSRIs-- and I'd question him if he did. I've heard that after stopping SSRIs, sometimes they don't work as well when you start back up. Tricyclics, also are themselves known for weight gain. (I didn't have any on them, though.) And the risk of going off SSRIs and going into a depression is *much* scarier to me than dealing with weight gain.
Posted by Jay on January 31, 2001, at 22:57:49
In reply to Re: weight gain/pharmaceutical research, posted by Ignatz on January 31, 2001, at 18:57:05
> I'm cautious about the idea of going off of SSRIs after 5 years; this might work for some people, but it might prove dangerous for others. For example, I ended up on Zoloft after 2 nasty depressive episodes (one at age 13, one at age 27), a family history of depression, and a very partial response to treatment with a tricyclic (nortriptyline). I gained 35 pounds on Zoloft, but my p-doc has never mentioned stopping SSRIs-- and I'd question him if he did. I've heard that after stopping SSRIs, sometimes they don't work as well when you start back up. Tricyclics, also are themselves known for weight gain. (I didn't have any on them, though.) And the risk of going off SSRIs and going into a depression is *much* scarier to me than dealing with weight gain.
I agree completely, and I think I missed my major point...and that is just a complete *evaluation* regardless of what med we are on. It would be HORRID and cruel to tell somebody to stop taking a med that has helped heal such complex psychiatric illness. It's just "weighing in" (as a metaphor, not actual..hehe.) of a balance sheet of good things, and less effective things that are/have worked. When I talk about "weight gain", I am pretty much talking about "obesity" (sp?), and massive extra weight that can harm us, especially many of us going through the 30-40 year old transitions. We have to be careful about everything from heart disease, diabetes, to cancer, which goes on a slippery scale after we reach a certain age, as we all know.
It most certainley has nothing to do with being over any "average" (which are usually way too thin). I talk of this because I suffered from much weight gain in my teens..lost it in my 20's, but gained a good chunk back when I went on a.d's, and SSRI's specifically. Of course, yes, the TCA's cause weight gain. Basically, I am just saying we should be aware, and ready to confront, weight gain issues with the newer meds (say minus meds like Welbutrin and similar). It' seems a bit easier to handle what we are prepared for, rather then not, as always.
Anyhow, it's just all IMHO, YMMV, etc. An important long-term concern, for sure. Again, it just needs to be looked at in a healthy way, not just because of any anti-med bull. I hope that clears that up...
Thanks..
Jay
Posted by Ignatz on February 1, 2001, at 8:30:27
In reply to Re: weight gain/pharmaceutical research » Ignatz, posted by Jay on January 31, 2001, at 22:57:49
Thanks for the clarification...It seems to be an issue of p-doc (or whoever's prescribing the meds) awareness and sensitivity, no? Ideally, p-docs would listen empathetically, take our reports of side effects seriously (even if there isn't research supporting our anecdotal evidence yet, as with weight gain on SSRIs), and talk through other options with us if we want to. My current p-doc does, but I think it's because I come in every six months for a med check and pepper him with questions. (I must be a real joy to see in his doorway!)
And maybe some people *don't* need to be on SSRIs their whole lives...
Posted by Davidc on March 8, 2001, at 9:38:32
In reply to Re: weight gain/pharmaceutical research, posted by Ignatz on February 1, 2001, at 8:30:27
Thanks for the information, its nice to know that I'm not alone struggling with this. The medication information says I should lose weight, but I have gained. I had a severe brainstem stroke (total paralysis and long recovery process). After zoloft I had gained upwards of 70lbs. I chalked it up to the imposition of a sedentary life due to the stroke. I have made a slow recovery back towards normal. I left zoloft (which made me zombielike) and began effexor. Through a low carb diet and 5 days a week at the gym I have peeled away 60 pounds. But that is where I have been stuck since sept of 2000. No matter what I do, more cardio, less food, more frequent small meals, more water, more weight training, the weight doesn't budge. I seriously feel that antidepressants play with one's metabolism, not affecting each unique person the same. I have now discontinued effexor, trying to row my own boat, hoping my brain has healed enough post stroke to allow me to do so. I also am hoping that the discontinuation of medication will allow me to resume weight loss. I agree be happy with who you are, but I also know that less physical weight will make another stroke less likely. Believe me, suffering a stroke is no fun and no picnic.
Anyone interested in my journey back there is a website at www.nconnect.net/~coopcrew detailing my progress since the intitial locked-in syndrome of total paralysis. Its not a depressing story, but one of hope .. so if you are down today and need to smile and say that there is hope ahead, take a look. Thanks for taking the time to read. :) David
Posted by Pannie S. on August 16, 2001, at 16:32:05
In reply to Re: weight gain/pharmaceutical research, posted by Davidc on March 8, 2001, at 9:38:32
I just found this site. 3 weeks ago I decided to go off Prozac after over 1 year of use at 80 mg/day.
I must say it is largely due to the way that the med "petered-out" a couple of months ago. When I first went on
Prozac I lost 20 lbs (and didn't need to). As it "petered-out" I started to gain weight regardless of my exercise/eating habits. A recovering anorexic, this
is very scary for me...also I have learned many coping mechanisms over the past year which Prozac enabled me to learn. I realize it's risky to go off the med, but I want to go it alone and see if I need to take it for the rest of my life.
I have been very tired and still gaining weight (the 20 lbs are back along with 10 more). I'm a bit flighty, but am hoping that this all will
go away once the med is out of my system (6 weeks??). Has anyone experienced the same thing? If so, any advice on how to make this time a bit easier or how to take the weight off?
Thank you in advance!
Posted by Elizabeth on August 17, 2001, at 2:33:31
In reply to Re: weight gain/pharmaceutical research, posted by Pannie S. on August 16, 2001, at 16:32:05
> I just found this site.
Pannie --
Welcome. I'm sorry to hear that Prozac stopped working for you. Unfortunately, SSRIs and some of the other antidepressants seem to do that a lot of the time. Can you describe the relapse you're experiencing? Some people report a sort of apathy, lethargy, or amotivational syndrome after long-term SSRI use. If this is what is going on for you, it may indicate that you should avoid SSRIs. Perhaps others who have more experience with SSRIs than I have can offer advise about this.
Some suggestions I've heard for reversing SSRI poop-out (yes, that's the technical term :) ) include switching to a different SSRI, adding stimulants (e.g. Ritalin), and adding the opioid antagonist naltrexone. (I'm not too keen on the idea of giving a depressed person naltrexone, but some people say it helps them.)
You mentioned that you've had problems with anorexia nervosa in the past. That's a very hard-to-treat disorder which generally doesn't respond well to pharmacologic treatments (I wonder if benzodiazepines or Neurontin have ever been looked at). I'm impressed that you successfully recovered. May I ask how you were able to get past it?
As for the Prozac, it sounds like it's not helping anymore and is even making things worse in some ways. I would suggest talking to the doctor who prescribed it about either switching to another medication or discontinuing the Prozac. (Prozac is usually pretty easy to get off of, unlike some of the other newer ADs.) 5 or 6 weeks is a safe guess as to how long it will be before the Prozac is gone; it might take longer for the adaptive changes (tolerance?) to reverse.
-elizabeth
Posted by Pannie S. on August 17, 2001, at 11:28:35
In reply to Re: Prozac no longer working » Pannie S., posted by Elizabeth on August 17, 2001, at 2:33:31
Elizabeth -
Thank you for the information. It is immensely helpful to "hear" that what I'm going through is not abnormal! I AM experiencing the apathy, lethargy, etc. that you described. I often go home for my lunch hour and sleep...I could sleep almost any time - anywhere, but find it difficult at bedtime. I went on Prozac largely to enable me to focus and be effective in my job...the depression/anorexia had made this virtually impossible. The Prozac helped and this enabled me to focus on work and pour myself into weekly private therapy in which I delved into the reasons behind my slide into anorexia. For me, anorexia provided control over one aspect of my life while I had virtually none over the rest...and never had. It wasn't my first bout with the disease...but by far the most successful by way of recovery. I am 28 and have been active in private and group therapy for 1.5 years...let's just say that through day after day of "homework" and an intense desire to leave my disease behind me, I was able to find strength inside myself with which I have been able to intensely modify many "rapid-fire" behaviors which fed many insecurities. I fear slipping back into a depressed state due to my stopping Prozac, as I have finally managed to move so far ahead in my life. My current symptoms mimic those of depression...AND I'm gaining weight! Yes, I expected to gain...and have done so slowly as part of my recovery from anorexia, but the gain which accompanied the "poop-out" of Prozac has been fast and furious. I now have cellulite in spite of the fact that I have joined my husband (a Sports Medicine teacher/athletic trainer) in the Body For Life exercise/nutrition program. We eat better than I ever have and exercise sensibly 6 days/week. Yet, I've gained at least 10 more lbs since starting the program! I've been much happier not being thin as a rail, healthy looks great! However, over the space of 8 weeks, I am now flabby. I will trust your advice and play the waiting game. I'm getting close to the 5-6 weeks when Prozac should leave my system. All I can do is hope that all returns to normal after that. I don't want to go on another medication. I'm (or was) confident that I have accumulated the skills to enable me to live drug-free. Here's hoping...it's just very tough to keep the faith as my mood and body change daily for the worst.
Thank you again...any further information you (or anyone else out there) can send my way is greatly appreciated!
Posted by MB on August 20, 2001, at 14:48:23
In reply to Re: weight gain/pharmaceutical research, posted by Pannie S. on August 16, 2001, at 16:32:05
I had a psychiatrist tell me that taking inositol (a nutritional supplement--I think one of the B-vitamins) can counteract the "poop-out" of SSRIs. He said it would help the fatigue, carbo-cravings, and apathy. I have not tried this myself, but he gave a pretty eloquent description of the mechanism involved (but I can't remember it--darn!)
Posted by Elizabeth on August 22, 2001, at 12:50:00
In reply to Re: Prozac no longer working, posted by Pannie S. on August 17, 2001, at 11:28:35
> Thank you for the information. It is immensely helpful to "hear" that what I'm going through is not abnormal!
Great! I understand the feeling.
> I AM experiencing the apathy, lethargy, etc. that you described.
Is it a relapse of your original depression, or is it something new? (Or both?)
> I often go home for my lunch hour and sleep...I could sleep almost any time - anywhere, but find it difficult at bedtime.
Heh -- I do that too, but I've always been like that.
> I went on Prozac largely to enable me to focus and be effective in my job...the depression/anorexia had made this virtually impossible. The Prozac helped and this enabled me to focus on work and pour myself into weekly private therapy in which I delved into the reasons behind my slide into anorexia.
I think antidepressants can facilitate talk therapy -- I've found that it's nearly impossible for many people to have successful talk therapy when they're not on effective medication.
> My current symptoms mimic those of depression...AND I'm gaining weight! Yes, I expected to gain...and have done so slowly as part of my recovery from anorexia, but the gain which accompanied the "poop-out" of Prozac has been fast and furious.
Many drugs can cause adaptive changes (and, often, tolerance to the therapuetic effect) with long-term use. There's no reason to suppose that SSRIs would be any different. Because you were on Prozac for a long time, you probably can expect it to take a while for the adaptive changes to reverse.
I wonder whether it might be worthwhile to get checked for endocrine problems, such as insulin resistance or hypothyroidism. Talk to your pdoc about the problems you're having, maybe s/he will have an idea of how to proceed.
> I've been much happier not being thin as a rail, healthy looks great!
It sure does, and it's great to hear that you've adopted that attitude. Anorexia is a very dangerous disease -- it has the highest mortality rate of any psych disorder -- and it's extremely hard to overcome. That you've been able to achieve recovery is a testament to your persistence.
> I will trust your advice and play the waiting game. I'm getting close to the 5-6 weeks when Prozac should leave my system.
That should be adequate. Maybe your doctor can prescribe something to make things easier during the washout period? I just mean a short-term thing; I know you don't want to be on medication for the rest of your life, and I understand. I felt the same way, but that didn't work out at all. So I recommend that you watch carefully for relapses during the months following your discontinuation of Prozac. MB's suggestion of inositol might be worth a try (it's one of the more respected "food supplements," if nothing else), and you could also search this site for past posts about SSRI poop-out.
Best wishes,
-elizabeth
Posted by anil on January 11, 2004, at 18:44:25
In reply to Re: Prozac no longer working » Pannie S., posted by Elizabeth on August 22, 2001, at 12:50:00
For all of those struggling with weight gain whilst on a ssri, here's a link that may help.
http://www.prozactruth.com/weight3.htm
It theorises that vitamin e and omega 3 supplementation will assist in weight loss and increasing one's metabolism.
LETS KEEP EACH OTHER POSTED
good luck.
anil
Posted by leah12 on March 23, 2006, at 13:00:03
In reply to Re: weight gain/pharmaceutical research, posted by Pannie S. on August 16, 2001, at 16:32:05
> I just found this site. 3 weeks ago I decided to go off Prozac after over 1 year of use at 80 mg/day.
> I must say it is largely due to the way that the med "petered-out" a couple of months ago. When I first went on
> Prozac I lost 20 lbs (and didn't need to). As it "petered-out" I started to gain weight regardless of my exercise/eating habits. A recovering anorexic, this
> is very scary for me...also I have learned many coping mechanisms over the past year which Prozac enabled me to learn. I realize it's risky to go off the med, but I want to go it alone and see if I need to take it for the rest of my life.
> I have been very tired and still gaining weight (the 20 lbs are back along with 10 more). I'm a bit flighty, but am hoping that this all will
> go away once the med is out of my system (6 weeks??). Has anyone experienced the same thing? If so, any advice on how to make this time a bit easier or how to take the weight off?
> Thank you in advance!Hello, today it is March 23, 2006 many years after I read this post. This is EXACTLY my situation. IF anyone out there can offer me help through their experience I would be more than appreciative!!! I am also a recovering anorexic--I only say recovering because I have gained sooooo much weight with Prozac. At first I dropped weight and felt GREAT...but as time went on I felt tired and depressed and gained weight, which made me feel even more tired and depressed. I upped my dosage (with my doc's ok) and it seemed to work for about a month, then I gained back what I lost and more. I am now heavier than I ever have been in my life. I am contemplating going off the meds. Any suggestions? Please help me--
This is the end of the thread.
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