Anti-depressant question

[jen83]

I am considering taking antidepressants for BPD. I was wondering whihc is the most effective with fewer side effects and causes weight loss. Also if I do go on the medication will I need to be on them for the rest of my life or will the sort out my brain chemistry after being on them for a certain length of time al;lowing me to discontinue them?
thankls for any insight

 

[jen83]

I am considering taking antidepressants for BPD. I was wondering whihc is the most effective with fewer side effects and causes weight loss. Also if I do go on the medication will I need to be on them for the rest of my life or will the sort out my brain chemistry after being on them for a certain length of time al;lowing me to discontinue them?
thankls for any insight

 

[David Baxter PhD]

1. It is difficult if not impossible to predict specific side-effects for a specific individual. For everyone who experiences side-effect A with medication X, there are many who do not experience that particular side-effect and many who don't experience any side-effects with that medication. The good news is that most people with a bit of trial and error can find one of the medfications in the SSRI family that will provide the desired benefits without undesirable side-efgfects.

2. That said, which medication is the least likely to cause side-effects seems to depend in part on what condition or symptom it is used to treat (e.g., depression vs. anxiety vs. obsessive-compulsive trends vs. panic attacks, etc., etc.).

3. Most people do not need to take these medications for life. In most cases, 1-2 years is sufficient. A few individuals seem to be more vulnerable to neurochemical imbalances than others and those people may need to be on the medications longer.

 

[David Baxter PhD]

1. It is difficult if not impossible to predict specific side-effects for a specific individual. For everyone who experiences side-effect A with medication X, there are many who do not experience that particular side-effect and many who don't experience any side-effects with that medication. The good news is that most people with a bit of trial and error can find one of the medfications in the SSRI family that will provide the desired benefits without undesirable side-efgfects.

2. That said, which medication is the least likely to cause side-effects seems to depend in part on what condition or symptom it is used to treat (e.g., depression vs. anxiety vs. obsessive-compulsive trends vs. panic attacks, etc., etc.).

3. Most people do not need to take these medications for life. In most cases, 1-2 years is sufficient. A few individuals seem to be more vulnerable to neurochemical imbalances than others and those people may need to be on the medications longer.

 

[jen83]

another question

do SSRIs tend to affect some peoples weight Im extrememly concerned about any weight gain that may be cause from medication.

 

[jen83]

another question

do SSRIs tend to affect some peoples weight Im extrememly concerned about any weight gain that may be cause from medication.

 

[David Baxter PhD]

Some can have that effect. That doesn't mean they necessarily will in your case.

Have you or another family member ever taken any of this type of medication before? Do you know which medication your doctor is considering or recommending for you?

Also, by BPD, do you mean bipolar disorder or borderline personality disorder? And what specific symptoms would you be taking the medication for?

Addendum:
I've just read another thread where you posted so i can see it is borderline personality with chronic depression and I gathered compulsive eating as the symptoms that most concern you?

One medication that you might find helpful is prozac, which tends to be more energizing and less sedating than some of the others. Another alternative is cipralex (lexapro) which for most people tends to have fewer side-effects than many others. A third might be Wellbutrin, which actually isn't an SSRI at all (it acts more directly on dopamine) but is effectivbe for some people in managing symptoms of depression.

Most often, if you experience a side-effect with one of the SSRIs, you can get around it by switching to another one in the same family. Sometimes, using a lower dose of one of the SSRIs with the addition of a low dose of Wellbutrin is effectibe in getting the benfits of an SSRI while minimizing any side-effects.

 

[David Baxter PhD]

Some can have that effect. That doesn't mean they necessarily will in your case.

Have you or another family member ever taken any of this type of medication before? Do you know which medication your doctor is considering or recommending for you?

Also, by BPD, do you mean bipolar disorder or borderline personality disorder? And what specific symptoms would you be taking the medication for?

Addendum:
I've just read another thread where you posted so i can see it is borderline personality with chronic depression and I gathered compulsive eating as the symptoms that most concern you?

One medication that you might find helpful is prozac, which tends to be more energizing and less sedating than some of the others. Another alternative is cipralex (lexapro) which for most people tends to have fewer side-effects than many others. A third might be Wellbutrin, which actually isn't an SSRI at all (it acts more directly on dopamine) but is effectivbe for some people in managing symptoms of depression.

Most often, if you experience a side-effect with one of the SSRIs, you can get around it by switching to another one in the same family. Sometimes, using a lower dose of one of the SSRIs with the addition of a low dose of Wellbutrin is effectibe in getting the benfits of an SSRI while minimizing any side-effects.

 

[jen83]

Dr. Baxter,
I was diagnosed with boarderline personality disorder. I was also diagnosed with ADHD when I was 10. I was wondering if you know of any correlations b/n both disorders. I was prescribed ritalin for several years and was wondering if it could be related to my current problem. When I was pregnant at the age of 15 my fits of rage ceased and I thought everything was fine; however the last couple years have been rather stressful and I've began "freaking" out on a regualr basis. Its very difficult to live this was and Im really skeptical about taking medication because Im afraid of causing further damage to myself.
thanks for your help and time

 

[jen83]

Dr. Baxter,
I was diagnosed with boarderline personality disorder. I was also diagnosed with ADHD when I was 10. I was wondering if you know of any correlations b/n both disorders. I was prescribed ritalin for several years and was wondering if it could be related to my current problem. When I was pregnant at the age of 15 my fits of rage ceased and I thought everything was fine; however the last couple years have been rather stressful and I've began "freaking" out on a regualr basis. Its very difficult to live this was and Im really skeptical about taking medication because Im afraid of causing further damage to myself.
thanks for your help and time

 

[David Baxter PhD]

If your doctor is aware of your medical history, including the Ritalin and the fact that the hormonal changes accompanying pregnancy made a difference, then I'd suggested you be guided by his or her advice.

I'd also suggest that it would be a good idea to have some standard blood tests first - look at hormone levels (which interact with brain chemistry), iron, B12, and thyroid function in particular.

 

[David Baxter PhD]

If your doctor is aware of your medical history, including the Ritalin and the fact that the hormonal changes accompanying pregnancy made a difference, then I'd suggested you be guided by his or her advice.

I'd also suggest that it would be a good idea to have some standard blood tests first - look at hormone levels (which interact with brain chemistry), iron, B12, and thyroid function in particular.

 

[Peanut]

jen83,
In response to your statement

do SSRIs tend to affect some peoples weight Im extrememly concerned about any weight gain that may be cause from medication.

My nurse practitioner gave me a scrpt for Paxil once and told me that that particular SSRI had a tendency to cause weight gain. I didn't take it because I didn't want to find out, but I thought I would pass that along, although I didn't really bother to read up on it much after she said that so I couldn't say for sure. I guess you just might want to be careful with that one in particular.

 

[Peanut]

jen83,
In response to your statement

do SSRIs tend to affect some peoples weight Im extrememly concerned about any weight gain that may be cause from medication.

My nurse practitioner gave me a scrpt for Paxil once and told me that that particular SSRI had a tendency to cause weight gain. I didn't take it because I didn't want to find out, but I thought I would pass that along, although I didn't really bother to read up on it much after she said that so I couldn't say for sure. I guess you just might want to be careful with that one in particular.

 

[David Baxter PhD]

Some are worse than others with respect to that side-effect but it is still true that many people taking these medications don't have ANY side effects.

If I were going to rank them based on patient reports (NOT a scientific sample obviously but from experiences of a fairly large number of clients over the years) I would say that Paxil is one of the worst both for side-effects and nasty withdrawal effects. That said, some people have had nothing but good experiences even with that medication.

 

[David Baxter PhD]

Some are worse than others with respect to that side-effect but it is still true that many people taking these medications don't have ANY side effects.

If I were going to rank them based on patient reports (NOT a scientific sample obviously but from experiences of a fairly large number of clients over the years) I would say that Paxil is one of the worst both for side-effects and nasty withdrawal effects. That said, some people have had nothing but good experiences even with that medication.

 

[sjambler]

Remeron and Zyprexa both caused weight gain when I took them, and my doctor said that they were some of the medicines most likely to do so.