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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 Paul on August 14, 1999, at 2:21:36
I'm currently taking Prozac, Effexor, and Klonopin. I've struggled with the fatigue that these cause for some time. I'm looking for something that boosts the appetite without increasing the fatigue/sedation. It seems like the TCA's, Periactin boost appetite, but cause big-time sedation. Maybe replacing the Effexor with Neurontin might work. It seems like Klonopin is the only thing that gives me any desire to eat. Anybody got any ideas? Paul
Posted by JohnL on August 14, 1999, at 10:55:37
In reply to Advice needed: Appetite booster that doesnt sedate, posted by Paul on August 14, 1999, at 2:21:36
Paul, Remeron increases appetite, and is a good augmentation with Prozac or Effexor. You would likely need to lower the dose of the Prozac and/or Effexor to be safe. Remeron is notorious for increasing appetite. Some nursing homes prescribe it to encourage senior citizens who aren't eating. It does cause sedation, take an hour or two before bed. But unlike the TCAs, the sedation doesn't usually carry over into the next day. It's usually gone by the time you finish your first coffee, and decreases with time. Larger doses cause less sedation and more hunger, but you would likely need to lower the dose of Prozac and/or Effexor. I've tried lots of ADs, and I still use Remeron on an as-needed basis for sleep. I've also used high doses of it in the past, so I'm familiar with it. Just an idea to consider.
In the herbal arena, I've heard many people swear by ginger's effectiveness for stomach upset. I'm not sure if that is the reason you don't have appetite, but just another easy idea to try.
You mentioned Neurontin. It is one of the two new generation mood stabilizers, Lamictal being the other. Neurontin is generally known to be sedating. Lamictal is rather neutral. Of course, there are those who get wired on neurontin, or get sedated on Lamictal. It's hard to predict. But I have heard lots of stories of Neurontin being sedating.
Personally I would think speaking to your doc about Remeron would be good. Others here will likely have good ideas to consider. Meanwhile, go treat yourself to some chocolate cake. :) JohnL.
Posted by Paul on August 14, 1999, at 13:56:58
In reply to Re: Advice needed: Appetite booster that doesnt sedate, posted by JohnL on August 14, 1999, at 10:55:37
> Paul, Remeron increases appetite, and is a good augmentation with Prozac or Effexor. You would likely need to lower the dose of the Prozac and/or Effexor to be safe. Remeron is notorious for increasing appetite. Some nursing homes prescribe it to encourage senior citizens who aren't eating. It does cause sedation, take an hour or two before bed. But unlike the TCAs, the sedation doesn't usually carry over into the next day. It's usually gone by the time you finish your first coffee, and decreases with time. Larger doses cause less sedation and more hunger, but you would likely need to lower the dose of Prozac and/or Effexor. I've tried lots of ADs, and I still use Remeron on an as-needed basis for sleep. I've also used high doses of it in the past, so I'm familiar with it. Just an idea to consider.
>
> In the herbal arena, I've heard many people swear by ginger's effectiveness for stomach upset. I'm not sure if that is the reason you don't have appetite, but just another easy idea to try.
>
> You mentioned Neurontin. It is one of the two new generation mood stabilizers, Lamictal being the other. Neurontin is generally known to be sedating. Lamictal is rather neutral. Of course, there are those who get wired on neurontin, or get sedated on Lamictal. It's hard to predict. But I have heard lots of stories of Neurontin being sedating.
>
> Personally I would think speaking to your doc about Remeron would be good. Others here will likely have good ideas to consider. Meanwhile, go treat yourself to some chocolate cake. :) JohnL.Thanks John for the helpful advice. Most of my appetite is getting knocked out by OTC ephedrine and the Prozac. It seems that the ephedrine is the only thing that gives me any energy. I take Klonopin 4mg. daily for social phobia, but as soon as I return home to a "safe" place, I crash unless I take the ephedrine. I honestly feel like Elvis, and know I'm on a bad road,(taking one downer then an upper.) I've lost about 30 lbs. in 5 months. My doc doesn't care, and hates patients who inform themselves. I've got an appt. to see a better doc. but I've gotta hold out til October, all the good docs are booked solid. So, I guess I need to take your advice and, much like Elvis, have some chocolate cake. Perhaps I'll shoot up my T.V. while I'm at it.(Just a little Elvis humor.)Thanks again John. Take care, Paul
Posted by Racer on August 14, 1999, at 18:53:20
In reply to Re: Advice needed: Appetite booster that doesnt sedate, posted by Paul on August 14, 1999, at 13:56:58
Ugh, too many meds, that's what I see. Have you been on the Effexor without the Klonopin? I've found that the very first and still strongest effect the Effexor has had for me was to relieve anxiety and social fears. Even though I was still depressed while on it, I could interact efficiently enough with others while taking the Effexor.
Everyone's different, but maybe cutting both the Klonopin and the OTC drugs all together would help.
Good luck.
Posted by janey girl on August 14, 1999, at 20:14:24
In reply to Re: Advice needed: Appetite booster that doesnt sedate, posted by Racer on August 14, 1999, at 18:53:20
Paul,
When I saw all of the meds you were on, it scared
me. Of course, I don't know what your diagnosis is,
but your body isn't going to be able to handle all
of that stuff for long without you paying the price
in some way.I'm glad to see you have an appt. to see another
doc. ~whew!~ I'm also surprised the Effexor hasn't
either kicked up your appetite, or slowed your
metabolism. It put 60 lbs. on me over a three-year
period -- exactly what I DIDN'T need.Good luck and wishes your way.
Posted by Paul on August 14, 1999, at 22:56:15
In reply to Agreeing with Racer here, posted by janey girl on August 14, 1999, at 20:14:24
> Paul,
>
> When I saw all of the meds you were on, it scared
> me. Of course, I don't know what your diagnosis is,
> but your body isn't going to be able to handle all
> of that stuff for long without you paying the price
> in some way.
>
> I'm glad to see you have an appt. to see another
> doc. ~whew!~ I'm also surprised the Effexor hasn't
> either kicked up your appetite, or slowed your
> metabolism. It put 60 lbs. on me over a three-year
> period -- exactly what I DIDN'T need.
>
> Good luck and wishes your way.Thanks for all the info. and support. From all the info. I received, I fully expected to be wired as hell from the Effexor, and expected it to even lessen my appetite. I've been taking it in the morning, and pretty much sleeping 16 hours after. This is on only 37.5 mg., which I'm sure is kicked up somewhat by the Prozac. Nobody seems to know how much, if at all. I know that the Prozac enhances the fatigue from the Klonopin, but can't seem to find anyone who knows whether Zoloft or Effexor do as well. It seems like they have fewer drug-drug interaction. I've also got a huge family history of hypothyroidism, but my current endocrinologist goes strictly by lab results, which have proven to be innaccurate. I agree with your advice, just wish I had more knowledge to go on. It seems like I spend 40 hrs. a week doing psych. research. That's definitely 40 hrs. more than my current doc.
If you don't mind, how about sharing your experience when starting Effexor(dosage which worked, side effects and their length, best time of day to take it, etc.)
Thanks again for the support and information. Paul
Posted by Elizabeth on August 15, 1999, at 1:44:44
In reply to Re: Thanks for the help , posted by Paul on August 14, 1999, at 22:56:15
One thing you might try is a vitamin B complex. It's good for you anyway. It worked for me at one point when I wasn't eating this winter and was actually extremely sensitive to cold as a result of not getting enough calories!
Posted by janey girl on August 15, 1999, at 7:55:21
In reply to Agreeing with Racer here, posted by janey girl on August 14, 1999, at 20:14:24
Hi Paul,
I began taking Effexor after Zoloft "pooped out" on me.
Once I was over the Zoloft withdrawal (which intensified
my depression at the time), and got a good level of
Effexor in my system, it felt great. At first I
experienced some anorexia with the Effexor (I was
started at 37.5, then increased to 75 mg bid over
the course of a month).Eventually, the Effexor needed to be increased to
150 mg bid; this year, when complaining of still
increasing insomnia, even while taking 300 mg of trazadone
before bedtime, my doc switched me to the 300 mg
Effexor XR to take in the morning.I can't say that the Effexor increased my appetite
quickly (or slowed the metabolism -- there's been
a lot of discussion on this -- increased appetite
vs. slowed metabolism with AD's). The weight gain
was gradual -- think about it -- 20 lbs. a year averages
out to gaining 1.2 pounds a month... I went from a
size 18 to a size 22 in three years, even with
exercise in my daily routine.The Effexor seemed to give me more energy, too.
I am now on Wellbutrin SR 150 mg a day (out of work, couldn't afford
the Effexor and doc didn't have samples; had samples
of Wellbutrin, so we're going that route now).What is your Klonopin for? You might ask your doc
to wean you off of the Prozac and get you on a
therapeutic dose of the Effexor, depending of course
why you're on the Prozac.The Effexor/trazadone combination and now currently
the Wellbutrin/trazadone combination is working
well for me. I have energy, I can sleep, my depression
is lifting. My "diagnosis" is dysthymia with major
depressive episode. I'm hopeful I can get off of
my meds forever in the next year or so.When it comes to increasing your appetite, be careful
with the Vitamin B6 -- don't take more than 300 mg
daily -- more than that is harmful to you.Maybe you should try adding Ensure or a high-calorie
protein drink to your diet, so you're getting the
vitamins and calories you need? It's a thought.We have this incredible ice cream here in Cincinnati,
Graeter's. It has like 350 calories a serving and
a serving is 1/4 of a pint. That'll put some
poundage on you. ~grin~ What's your favorite
flavor?Good luck and good wishes.
Posted by Paul on August 21, 1999, at 17:59:30
In reply to Paul, posted by janey girl on August 15, 1999, at 7:55:21
> Hi Paul,
>
> I began taking Effexor after Zoloft "pooped out" on me.
> Once I was over the Zoloft withdrawal (which intensified
> my depression at the time), and got a good level of
> Effexor in my system, it felt great. At first I
> experienced some anorexia with the Effexor (I was
> started at 37.5, then increased to 75 mg bid over
> the course of a month).
>
> Eventually, the Effexor needed to be increased to
> 150 mg bid; this year, when complaining of still
> increasing insomnia, even while taking 300 mg of trazadone
> before bedtime, my doc switched me to the 300 mg
> Effexor XR to take in the morning.
>
> I can't say that the Effexor increased my appetite
> quickly (or slowed the metabolism -- there's been
> a lot of discussion on this -- increased appetite
> vs. slowed metabolism with AD's). The weight gain
> was gradual -- think about it -- 20 lbs. a year averages
> out to gaining 1.2 pounds a month... I went from a
> size 18 to a size 22 in three years, even with
> exercise in my daily routine.
>
> The Effexor seemed to give me more energy, too.
>
> I am now on Wellbutrin SR 150 mg a day (out of work, couldn't afford
> the Effexor and doc didn't have samples; had samples
> of Wellbutrin, so we're going that route now).
>
> What is your Klonopin for? You might ask your doc
> to wean you off of the Prozac and get you on a
> therapeutic dose of the Effexor, depending of course
> why you're on the Prozac.
>
> The Effexor/trazadone combination and now currently
> the Wellbutrin/trazadone combination is working
> well for me. I have energy, I can sleep, my depression
> is lifting. My "diagnosis" is dysthymia with major
> depressive episode. I'm hopeful I can get off of
> my meds forever in the next year or so.
>
> When it comes to increasing your appetite, be careful
> with the Vitamin B6 -- don't take more than 300 mg
> daily -- more than that is harmful to you.
>
> Maybe you should try adding Ensure or a high-calorie
> protein drink to your diet, so you're getting the
> vitamins and calories you need? It's a thought.
>
> We have this incredible ice cream here in Cincinnati,
> Graeter's. It has like 350 calories a serving and
> a serving is 1/4 of a pint. That'll put some
> poundage on you. ~grin~ What's your favorite
> flavor?
>
> Good luck and good wishes.Thanks for the info janey! I'm on Prozac 20mg. and Klonopin 4mg. both for GAD, and recurrent depresssion. The doc just recently added 75mg. of Effexor, hopefully to boost energy. All these meds seem to knock me out, so as I stated earlier, I resort to ephedrine HCL for energy. I know it's dangerous, but I have to function. I've read recent posts on SSRI's and the benzo's disrupting sleep quality. That may be my problem. I'd also like to try a shorter acting benzo. I'll definitely try the ice cream idea. It just freaks me out that Effexor seems to hype everybody else up,and after I take it I make sure I'm near a bed? Wyeth-Ayerst also doesn't list drowsiness or sedation on side effects. I'm wondering if I might have more luck on Effexor SR. Thanks again for your info. Take care, Paul
Posted by janey girl on August 27, 1999, at 20:04:02
In reply to Re: Paul/to janey girl, posted by Paul on August 21, 1999, at 17:59:30
Paul,
Just checking in to see how your appetite is, and
how your medicine is working out? Eating some
ice cream or high protein drinks?Keep us posted.
janey girl
This is the end of the thread.
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