It is difficult NonBinaryHamster in your position to go by our experience because we all metabolize these drugs differently and will get different side effects, or none at all. Degree of effectiveness will vary widely.
The ones least likely to cause weight gain are Wellbutrin, amitriptyline, nortriptyline, and the SNRI's. Amitriptyline by about 2.5% is more effective than anything there is. Amitriptyline and norttriptyline are old TCA's and are much more likely to cause other side more serious side effects than the SSRI's and SNRI's.
The one most likely to cause weight gain is Remeron (Mirtazapine). It is also an excellent sleep aid. I take it and sleep like a baby each night. I am lucky and don't gain weight on it.
Depression itself for sure can cause insomnia and totally mess up circadian rhythms. SSRI's and SSNRI's can also interfere with sleep which is why I take Remeron for sleep. Other people take trazadone just for sleep. Both better than taking the ambiens's or benzo's......safer.
I would talk to your doc about Wellbutrin for you specific case and consider the SSNRI's like Fetzima, Effexor, Pristiq, Cymbalta. By far the most effective one I have ever taken and am on now is Fetzima. I have been taking them for twenty years. I have never gained weight but I am lucky.
Best Study on Weight Gain.
Antidepressants cause minimal weight gain - Harvard Health Blog - Harvard Health Publications
Quote:
|
Earlier studies linking antidepressant use to weight gain were usually small and short. This one, led by researchers with Massachusetts General Hospital’s Center for Experimental Drugs and Diagnostics, included more than 19,000 men and women and lasted for a year.
|
JAMA Network | JAMA Psychiatry | An Electronic Health Records Study of Long-Term Weight Gain Following Antidepressant Use
Quote:
significantly decreased rate of weight gain was observed among individuals treated with bupropion, amitriptyline, and nortriptyline
Antidepressants differ modestly in their propensity to contribute to weight gain.
|
You can't know for sure unless you try. Mileage may vary compared to all of us.
Consider the risks of SSRI's
What are the real risks of antidepressants? - Harvard Health Publications
Depression itself has very adverse effects on the brain, body, and your life. It is a risk vs benefit equation and there is not way to know unless you try. There is one genetic test that tests your genes to show how you will metabolize 12 different ones. Green, Yellow, Red. Green means metabolizing efficiently and supposedly less chance of side effects. Not sure how much it says about effectiveness.
GeneSightŪ
Personally if I were you based on what you have said I would go SSNRI. Fetzima first. Or Wellbutrin if the doc says that is ok.
Eating Disorders
Quote:
|
Bupropion (Wellbutrin) has been associated with seizures in purging bulimic patients and its use is not recommended.
|
Wellbutrin Disease Interactions - Drugs.com
Quote:
|
The use of bupropion is associated with weight alterations. Both weight gain and weight loss may occur, although the latter is much more common. The incidence of weight loss greater than 5 pounds is approximately 28%, which may be undesirable in patients suffering from anorexia, malnutrition or excessive weight loss. Weight change should be monitored during therapy if bupropion is used in these patients.
|
Binge Eating Disorder
http://www.currentpsychiatry.com/hom...115dd5776.html
Quote:
Bupropion has been more effective than placebo for treating:
uncomplicated obesity (short- and long-term)
obesity associated with depressive symptoms
bulimia nervosa (although bupropion is contraindicated in these patients because of seizure risk).26,28,29
No controlled trials have studied bupropion for BED. When using dosages effective in depressive disorders, we find bupropion helpful in reducing binge eating, body weight, and depressive symptoms in BED patients.
|
Seems the biggest contraindication for Wellbutrin would be with bulimia nervosa and purging being associated with seizures. I don't know the percentage. With anorexia and wellbutrin the concern would be to much weight loss. It looks to me it might be a very good drug for binge eating without purging and being over weight.
PS (I personally do not trust madinamerica or Robert Witaker as a source for my information. My opinion. I will take Harvard or the Cleveland Clinic any day and the actual studies themselves.)