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Re: Weight gain and SSRIs MB

Posted by Elizabeth on July 12, 2001, at 19:02:14

In reply to Re: Weight gain and SSRIs Elizabeth, posted by MB on July 11, 2001, at 18:30:34

> Doesn't Meridia work on Serotonin?

It's a serotonin-norepinephrine reuptake inhibitor, just like Effexor. It even resembles venlafaxine structurally There's no reason it wouldn't be just as good an AD as Effexor -- it wasn't marketed for this indication because the market for ADs was already saturated. But in early literature on sibutramine, it's referred to as an "antidepressant," not as a weight loss aid. (I would bet that it's a crappy diet pill, BTW. < g >) =

> It mentioned antagonism of 5HT-2c as a possible mechanism for neuroleptic weight gain.

Well, they're strong antihistamines too (hence the sedation). Do "typical" antipsychotics block the 5HT-2c receptor? Or is weight gain from these drugs attributed solely to the H1 blocking?

I'll take a look at that site.

> in fact, I think the guy stated that this was the puted mechanism of Meridia.

(You mean "putative," right?" I'm skeptical of that, since no other mechanisms have been IDed for Meridia besides monoamine reuptake inhibition, AFAIK.)

BTW, SSRIs and Effexor don't "make people fat" across the board, and it's not clear that it's even a majority side effect. The people who gain weight are the ones who complain. As I mentioned, I took Prozac for between two and three years, and I didn't gain weight beyond my baseline weight *or* regain the weight that I'd lost while depressed.

> I gorge myself when I'm dysthymic or anxious, but I barely eat when i'm *really* depressed.

Perhaps you have two different problems going on at the same time. I think this might be what's happening with me (although I have fewer and subtler "atypical" symptoms).

> That would go against an atypical dx, wouldn't it?

Yes, but the subtypes haven't been defined perfectly yet. Constructing subtypes based on medication response is simply the most pragmatic way to go about doing clinical research until we have a better understanding of how the brain works (and how it malfunctions).

> Yeah, I gained about 30lbs while taking Paxil. I've gotten my body fat back down to about where it was before I started, but my body is just stockier and heavier...shaped's like the Paxil just permanently changed my body type, or something. Or, maybe it's just hitting 30 yrs old that did it.

People do tend to get heavier as they age. I easily lost all the weight I gained on Nardil -- I call it "the depression diet" -- but because I switched directly to Parnate, the weight from Marplan hasn't gone away completely. Losing weight is *hard*.





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