Shown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by gman22 on September 10, 2012, at 16:40:58
I had full remission on sertraline and nortriptyline combo. Stayed on them both for about one year, but gained 25lbs. Got rid of nortriptyline, lost 25lbs. After another year I withdrew the sertraline and lost another 10 lbs, but symptoms of anxiety and depression returned. Now I'm going back to sert/nort 50mg/50mg. Has anyone been able to successfully avoid weight gain from TCAs.
Posted by SLS on September 10, 2012, at 18:17:26
In reply to Nortriptyline weight gain, posted by gman22 on September 10, 2012, at 16:40:58
> I had full remission on sertraline and nortriptyline combo. Stayed on them both for about one year, but gained 25lbs. Got rid of nortriptyline, lost 25lbs. After another year I withdrew the sertraline and lost another 10 lbs, but symptoms of anxiety and depression returned. Now I'm going back to sert/nort 50mg/50mg. Has anyone been able to successfully avoid weight gain from TCAs.
You could try desipramine.
- Scott
Posted by jono_in_adelaide on September 10, 2012, at 18:32:37
In reply to Nortriptyline weight gain, posted by gman22 on September 10, 2012, at 16:40:58
It might be worth trying sertraline plus welbutrin instead of nortriptyline.
Posted by jono_in_adelaide on September 10, 2012, at 18:36:45
In reply to Re: Nortriptyline weight gain, posted by jono_in_adelaide on September 10, 2012, at 18:32:37
or desipramine
So - Sertraline 50mg/day plus either
Welbutrin 300mg/day or
Desipramine 100-200mg/day
Both of these hit noradrenalin so should offer similar benifits to nortriptylein, but shouldnt encourage weight gain (Welbutrin can sometimes even encourage some weight loss)
Posted by gman22 on September 10, 2012, at 19:07:53
In reply to Re: Nortriptyline weight gain, posted by jono_in_adelaide on September 10, 2012, at 18:36:45
I'd like to try desipramine or wellbutrin but I'm a little afraid of anxiety creeping back in. Maybe I should just take imipramine (which I used successfully without much weight gain).
Posted by SLS on September 10, 2012, at 19:24:34
In reply to Re: Nortriptyline weight gain, posted by gman22 on September 10, 2012, at 19:07:53
> I'd like to try desipramine or wellbutrin but I'm a little afraid of anxiety creeping back in. Maybe I should just take imipramine (which I used successfully without much weight gain).
Sounds good to me. You already know what to expect. What is the dosage range that you would target?
- Scott
Posted by gman22 on September 10, 2012, at 19:48:19
In reply to Re: Nortriptyline weight gain » gman22, posted by SLS on September 10, 2012, at 19:24:34
150mg of imipramine pulled me from completely disabled to very high functioning in a few weeks. I think my Dr is hesitant to prescribe it to me because he thinks I was hypomanic on it. I did learn how to play piano and started a business in under a year...ahh the good ol' days
Posted by Bob on September 11, 2012, at 0:48:54
In reply to Re: Nortriptyline weight gain..SLS, posted by gman22 on September 10, 2012, at 19:48:19
> 150mg of imipramine pulled me from completely disabled to very high functioning in a few weeks. I think my Dr is hesitant to prescribe it to me because he thinks I was hypomanic on it. I did learn how to play piano and started a business in under a year...ahh the good ol' days
If you didn't gain significant weight on imipramine and it seemed to work so well, why did you eventually discontinue it?
Posted by gman22 on September 11, 2012, at 8:09:19
In reply to Re: Nortriptyline weight gain..SLS » gman22, posted by Bob on September 11, 2012, at 0:48:54
I gradually weaned off after a year because it was my first episode, and I went to a 6 year remission....
Posted by Bob on September 11, 2012, at 10:44:35
In reply to Re: Nortriptyline weight gain..Bob, posted by gman22 on September 11, 2012, at 8:09:19
> I gradually weaned off after a year because it was my first episode, and I went to a 6 year remission....
What led you to try something else when you relapsed rather than going back on imipramine? What reservations would you have at this point about trying it again?
Posted by gman22 on September 11, 2012, at 11:15:32
In reply to Re: Nortriptyline weight gain..Bob » gman22, posted by Bob on September 11, 2012, at 10:44:35
I do a lot of strenuous exercise, so my dr. wanted something with no cardiac side effects. I took Paxil and most of the other SSRIs, but they have never measured up to the response from imipramine.
I am still worried (maybe unjustly) about cardiac issues....
Posted by SLS on September 11, 2012, at 11:32:44
In reply to Re: Nortriptyline weight gain..Bob, posted by gman22 on September 11, 2012, at 11:15:32
> I do a lot of strenuous exercise, so my dr. wanted something with no cardiac side effects. I took Paxil and most of the other SSRIs, but they have never measured up to the response from imipramine.
> I am still worried (maybe unjustly) about cardiac issues....I have taken imipramine while doing some heavy-duty resistance exercise. Your heart rate would be higher, and you might want to take some extra time between sets. Just test the waters a little at a time. It might be a good idea to get a ECG before and after starting imipramine.
- Scott
Posted by Bob on September 11, 2012, at 11:34:10
In reply to Re: Nortriptyline weight gain..Bob, posted by gman22 on September 11, 2012, at 11:15:32
> I do a lot of strenuous exercise, so my dr. wanted something with no cardiac side effects. I took Paxil and most of the other SSRIs, but they have never measured up to the response from imipramine.
> I am still worried (maybe unjustly) about cardiac issues....
Is it your doctor or you that's more worried about cardiac issues?I take 150mg nortriptyline daily and I do strenuous exercise. Maybe that's not a good idea but my doctor knows and has never said a thing.
Are there any other reasons why you wouldn't take it?
Posted by bleauberry on September 11, 2012, at 12:21:19
In reply to Nortriptyline weight gain, posted by gman22 on September 10, 2012, at 16:40:58
I lost weight on nortriptyline.
Your best bet, if you want to stay in remission and simultaneously improve overall health, is to be very careful and very picky about what goes in your grocery cart, and in your mouth. Some meds are harder than others.
If you don't give your diet attention, it will take it. That's 25 pounds later of course.
Zyprexa, nardil, and depakote seem especially difficult in the weight gain area, but even they can be managed pretty good. It just depends on whether the patient really wants to be well, I mean really well through and through, or whether they just want their head to feel good.
Posted by gman22 on September 11, 2012, at 17:57:18
In reply to Re: Nortriptyline weight gain..Bob » gman22, posted by Bob on September 11, 2012, at 11:34:10
My dr. says TCAs are very safe at the correct dosages..I'm just a little paranoid of cardiac issues because I also have panic disorder..I think I will stay on the sert/nort combo for now and see if I can eat better...If that fails I will go back to imipramine.
Posted by jono_in_adelaide on September 11, 2012, at 18:13:33
In reply to Re: Nortriptyline weight gain, posted by bleauberry on September 11, 2012, at 12:21:19
Unless you have pre existing heart disease, the cardiac side effects of the TCA's arnt worth worrying about, especialy if you are on a low dose (eg 75mg of nortriptyline)
If you want a robust antidepressant combo that also helps with anxiety, and with no weight gain and no cardiac side effects, I'd try an SSRi (say sertraline 50-100mg/day) plus bupropion 300mg/day
Posted by jono_in_adelaide on September 11, 2012, at 18:15:03
In reply to Re: Nortriptyline weight gain, posted by jono_in_adelaide on September 11, 2012, at 18:13:33
But if imipramine worked well for you, and didnt cause weight gain, I'd use it..... the chances of it causing cardiac effects in a person without some preexisting cardiac disease are about the same as being run over my a truck..... so small they arnt worth worrying over
Posted by Phillipa on September 11, 2012, at 18:36:36
In reply to Re: Nortriptyline weight gain, posted by jono_in_adelaide on September 11, 2012, at 18:15:03
Personally I'd try to find a med combo that doesn't have this side effect. How bad is the depression? Still working? Phillipa
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