[NonBinaryHamster]

Hey,

So, I've been seeing cousellors, psychologists, psychiatrists and doctors for over ten years now (I'm only in my early twenties) and they have all recommended me taking antidepressants for my depression. I also have a binge eating disorder.
Anyway, I am finally starting to accept that they could be good for me - I don't want to continue feeling this way all the time, it's intererring with my life far too much.

The thing is, if I am to go on meds, I want to be heavily involved in the process of choosing the rigt meds for me. I've done a lot of research, but a lot of my information contridicts itself in many places, especially considering weight changes as a side effect.
I fear gaining weight more than anything, and have been doing so a lot lately due to the eating disorder. So, I don't want one that is likely to make me gain weight. I suffer with insomia, too, so can't take ones that are likely to make that worse, which many seem to be.

The one that's stood out for me mostly is Wellbutrin. Though doctors aren't supposed to give that to people with eating disorders. Was wondering if any of you have any advice or opinions of ones I should discuss with my doctor before I see him in two weeks? Any input would be appreciated, and I know that it's a process to find one that both works and I'm happy about, I've no illusions about this.

Thanks

[vital]

Originally Posted by NonBinaryHamster

Hey,

So, I've been seeing cousellors, psychologists, psychiatrists and doctors for over ten years now (I'm only in my early twenties) and they have all recommended me taking antidepressants for my depression. I also have a binge eating disorder.
Anyway, I am finally starting to accept that they could be good for me - I don't want to continue feeling this way all the time, it's intererring with my life far too much.

The thing is, if I am to go on meds, I want to be heavily involved in the process of choosing the rigt meds for me. I've done a lot of research, but a lot of my information contridicts itself in many places, especially considering weight changes as a side effect.
I fear gaining weight more than anything, and have been doing so a lot lately due to the eating disorder. So, I don't want one that is likely to make me gain weight. I suffer with insomia, too, so can't take ones that are likely to make that worse, which many seem to be.

The one that's stood out for me mostly is Wellbutrin. Though doctors aren't supposed to give that to people with eating disorders. Was wondering if any of you have any advice or opinions of ones I should discuss with my doctor before I see him in two weeks? Any input would be appreciated, and I know that it's a process to find one that both works and I'm happy about, I've no illusions about this.

Thanks

I would advise you to have a look at this paper describing the negative effects of antidepressants:

Negative Effects of Antidepressants | Mad in America

This video by Robert Whitaker is also very illuminating as a study of long term outcomes and as to why these drugs are prescribed so much.

What I personally think is the best plan for dealing with depression is explained here

http://forums.psychcentral.com/4162657-post74.html

- vital

[Rohag]

Hello, NonBinaryHamster.

Originally Posted by NonBinaryHamster

The one that's stood out for me mostly is Wellbutrin. Though doctors aren't supposed to give that to people with eating disorders.

My shallow understanding is that Wellbutrin is contraindicated for people with bulimia or anorexia, not binge eating without purging. That's something to discuss with the doctors.

Weight gain is a legitimate concern with antidepressants - my observation.

Consider focusing first on treating the insomnia. Winning that battle may significantly help the depression. (Antidepressants have generally helped with my insomnia.)

[NonBinaryHamster]

Originally Posted by Rohag

My shallow understanding is that Wellbutrin is contraindicated for people with bulimia or anorexia, not binge eating without purging.
...
Consider focusing first on treating the insomnia. Winning that battle may significantly help the depression. (Antidepressants have generally helped with my insomnia.)

The binge eating that I have stemmed from bulemia, which is why that's a concern. Not purging in between is only a recent thing.

& I've tried treating the insomnia first already. I've tried both natural methods and going on sleeping pills for a period of time to try kickstart a normal pattern. My doctor now firmly believes that it's because of the depression and that antidepressants are the best way to go.

[marmaduke]

I don't understand people that are against anti depressants. They work well for many people. At the moment its trial and error when it comes to finding one that works for you.

[NonBinaryHamster]

Originally Posted by marmaduke

I don't understand people that are against anti depressants. They work well for many people. At the moment its trial and error when it comes to finding one that works for you.

I'm not against them, I just wanted to try every other way of getting over things naturally.. & now that I've tried everything suggested to me by my doctor, I'm trying meds. Just want some suggestions of which ones to discuss with him.

I was prescribed Wellbutrin and it did nothing for me. No weight gain, no aid in my depression. However, when I went off it my life became hell. It damaged my brain so that I have panic attacks and anxiety attacks every evening. Now I have to stay on an SSRI because of what Wellbutrin did to me. Wellbutrin was given to me like it was going to save me but it only made my life a nightmare. You've been warned. These drugs may effect your brain chemistry.

[lestercat]

Go for it, it's all part of the cure if indeed there is one.

[Altered Moment]

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

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

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.

GeneSight®

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

Bupropion (Wellbutrin) has been associated with seizures in purging bulimic patients and its use is not recommended.

Wellbutrin Disease Interactions - Drugs.com

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

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.)

[Altered Moment]

If you read an article such as this below check out the sources and studies cited (if there are any). Some paragraphs have links some do not. There is no list of references at the end of the article. I have seen a number of articles on madinamerica where no sources are listed except to other articles or books written by the author. The sources should be original and the claims should be based on the whole body of scientific knowledge, all the studies, and the most current ones. If you want the most accurate information you have to be willing to do some foot work and research. Check the studies cited and then google all the studies there are on a specific claim.

http://www.madinamerica.com/2012/09/...tidepressants/

For example I can show you where this statement from the article is totally not true. References "our article"

Antidepressants can kill neurons (see our article for a review). Many medical practitioners will be surprised by this fact because it is widely believed in the medical community that antidepressants promote the growth of new neurons. However, this belief is based on flawed evidence—a point that we address in detail in our article.

"is based on flawed evidence" is totally untrue. “Flawed evidence” refers to the original studies on the subject and how the methods used only showed cell proliferation (birth of cells) and not neurogenesis (cell maturation). However many subsequent studies have employed different methods that do show neurogenesis. The below article explains it well along with all the other studies listed below. So to me if an author misrepresents what all the evidence shows on a topic than I longer trust that author. I have seen Robert Whitaker misrepresent studies claiming something to be true when the authors of the study claim no such thing. This blows his credibility to me.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC400689/

Antidepressants do cause neurogenesis in the hippocampus and other parts of the brain. Neurogenesis, cell proliferation, cell maturity, cell migration, synaptogenesis, and differentiation into neurons and glial cells. Below is the proof.

Neurogenesis and antidepressants.

http://www.scientificamerican.com/ar...is-depression/

http://www.nature.com/npp/journal/v3...npp20132a.html

http://www.ncbi.nlm.nih.gov/pubmed/23303069

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3121947/

http://www.jneurosci.org/content/20/24/9104.full

http://dujs.dartmouth.edu/news/the-f...genesis-theory

http://www.ncbi.nlm.nih.gov/pubmed/21861813

http://www.hindawi.com/journals/np/2013/805497/

http://www.cumc.columbia.edu/publica...s14_sept15_03/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC514842/

http://www.rsc.org/chemistryworld/Ne...l/12041101.asp

http://www.biologicalpsychiatryjourn...581-6/abstract

http://www.cell.com/trends/pharmacol...2814%2900165-5

http://www.biopsychiatry.com/newbraincell/

http://www.nature.com/npp/journal/v3...npp20135a.html

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC400689/

http://psychiatryonline.org/doi/full...ajp.160.8.1516

http://www.sciencedirect.com/science...71489206001718

http://journals.plos.org/plosone/art...l.pone.0017600

http://www.nature.com/tp/journal/v3/...tp201330a.html

http://www.jneurosci.org/content/25/5/1089.full.pdf

http://www.ncbi.nlm.nih.gov/pubmed/15689544

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC400689/

[Clara22]

Hi,
I am taking fluoxetine for anxiety and depression and also is helping a lot to reduce my binge eating. I have lost weight since I started with fluoxetine

[marmaduke]

All meds can have problems, aspirin which you can buy anywhere can cause bleeding if taken in excess, Paracetamol can kill.

Anti depressants have been around since the 1950s and are relatively safe.
Ideally meds would not be needed, and everyone would be well all the time

I tried Prozac, didn't work for me. Then I tried Paroxetine which works well