Cam, just wondering about what you said about TCAs not being as bad for weight gain as SSRIs. Is that just your clinical experience? Or have you seen anything in the literature?

I'm nuts on this topic, having gained HUGE amounts of weight on the only TCA I was ever able to tolerate, on SSRIs, and one Effexor XR/Prozac combo. It's a big part of the reason I'm hard to treat -- the second a doctor starts to minimize the whole weight gain thing, I leap to the conclusion that this doctor Is Not Listening To Me, you know? (Yeah, well, we all have our little quirks, right?)

For what it's worth, about the Paxil weight gain: I was started on Paxil during an active anorexic episode in my life. For some time, my BMI had been in the 15 to 16 range, I was actively restricting, and overexercising. Without any change in those habits, and without any remission for my depression, I began gaining weight. The weight gain began early on, it continued as long as I took Paxil, and it didn't come off when I stopped. In fact, it was only when I had a relapse in the anorexia that any weight came off -- despite a very active life, a lot of exercise, and despite the fact that I had NEVER in that entire time eaten a normal amount of food.

Gee. You think there's any correlation between this sort of experience, the doctors telling me that it was my fault for eating too much and being lazy, and my lack of overwhelming trust for doctors?

Thankfully, of course, we have the Cams of the world. Thank you.