I Need Help " Anti-depressants"

[UrSexyLatinDr21]

HI

I have some questions. My cousin, a 21 year old male was sent after therapy to a psychiatrist because he has some depression caused by his weight problem. He is overweight and became a very insecure person, which caused depression on him. He has tried to anti-depressants. Effexor and Lexapro. He stopped taking these because of the sexual side effects. As he said, the sexual side effects became worse then the depressed moments he was having. He has been doing some research and I ve helped him a bit. So far we have found that "Wellbutrin" Bupropion is an antidepressant which has the less side sexual effects and shows no weight gain. Looks perfect for him. I also read about Luvox. WHat do you guys think? Is there any other anti-depressant of which you guys might know that has no sexual nor weight gain effects? He has an appointment in 5 days, I will really appreciate any information.

Sincerely,

Eduardo

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[Histrionic]

Serzone (Nefazodone) has no sexual dysfunction, very low weight gain and moderate sedation.

 

[UrSexyLatinDr21]

Thanks for your responses guys....ALso, he has some slight OCD, but this ocd occurs when his anxiety is a bit up, but nothing to bad. SO it looks, like serzone and wellbutrin are the meds to look at , right?


Eduardo

 

[kumar28]

I'm not sure how effective serzone is for OCD? Does anyone have any info on this?

 

[redruckus]

Wellbutrin is great. I took it for my clinical depression episode during high school. I didn't notice any real side effects except I had a lot more energy and actually lost weight which is good. So I definitely recommend it.

I don't really know how it interacts with OCD though. If his OCD is related to anxiety, I know Paxil is supposed to aid both so maybe that will work.

Hope you cousin finds the right treatment and feels better!

 

[El Duderino]

Serzone (Nefazodone) has no sexual dysfunction, very low weight gain and moderate sedation.

... and some serious hepatotoxicity.

I didn't know bupropione was regularly prescribed for depression. What makes it a better/worse option than SSRIs?

 

[Psychobabble]

Bupropion (Wellbutrin) has a chemical structure similar to amphetamine, and works primarily through Dopamine effects. It is a weak neuronal inhibitor of dopamine, norepinephrine and serotoninIt has also been used to treat ADHD (but not in children) and bipolar d/o. Patients may experience slight weight loss, but not everyone does. It is not used for control of OCD.

Wellbutrin carries a risk of seizures, particularl at high dosages (higher than therapeutic, ie. more than 450 mg/day). However, seizures have occurred at lower doses, ranging from a risk of .1% to .4%. It is controversial whether to prescribe to a patient with seizure disorder; some say the sustained-release form (Wellbutrin-SR) may be used if started slowly and kept at a lower dose. It should not be prescribed for patients taking meds that lower the seizure threshold (antipsychotics, some antidepressants, steroids, theophylline, etc.)

As Zyban, it is also approved for treatment of smoking cessation.

Hope this helps!

 

[Cubs2002]

I take Wellbutrin myself at 150mgx2 ED. And have been on it for 4 years now. There have been literally no side-effects except a decrease in appetite. Sexual sides are non-existent. Zoloft is currently being perscribed for OCD however the risk of sexual sides is quite high, i.e. impotence, trouble achieving orgasm.

 

[Cubs2002]

It should not be prescribed for patients taking meds that lower the seizure threshold (antipsychotics, some antidepressants, steroids, theophylline, etc.)

[/B][/QUOTE] I have been running 250mg of Test Cypionate every 2 weeks along with the Wellbutrin and have had no harmful interactions.

 

[MD OR RN?]

Ive been on Celexa(Citolpram) for sometime now with no real side effects when taking it alone. It is used as an anti deppresant. It never took off like some other anti deppresants but it is a newer drug.

I would defintly look into the medicine.

 

[Thewonderer]

Seriously, your cousin needs to lose weight first. Atkins diet has some new found scientific backing to it now. Some believe that it causes a mild form of ketoacidosis, thereby changing the way you burn energy.

The bottomeline is that people are much better in terms of compliance with Atkins diet than the low-fat diets, so you do a better job keeping your weight down.

A lecturer has shown some studies where LDL decreases slightly on Atkins diet but the key is that triglyceride decreases drastically while, somewhat paradoxically, HDL increases signficantly. Therefore, Atkins diet might actually improve your lipid profile.

Obesity is the #1 public health enemy. Losing some weight might help your cousin more than any antidepressant!

 

[BPKurtz]

Antidepressants usually work on 3 different neurotransmitter systems: serotonin, norepinephrine, and dopamine. Lexapro acts rather exclusively on the serotonin system (it is called an SSRI or selective serotonin reuptake inhibitor). Effexor has SSRI effects and also acts on the norepinephrine system (especially at higher doses). Wellbutrin acts primarily on the dopamine system. It could be argued that on someone who has failed Lexapro and Effexor, Wellbutrin might be a reasonable choice because it acts in a different way. (This argument is somewhat misleading because people who fail to respond to one SSRI often do great on another, although it's not clearly understood why.) But anyway the side effect profile of Wellbutrin is pretty favorable and in fact sometimes causes appetite decrease/weight loss which is good. I think having your friend talk to a physician and involving him/her in your thought process about antidepressant choice (or whether an antidepressant is really appropriate at all) would be a good idea.

The issue of OCD is separate. It isn't clear from your original post whether he has been diagnosed (preferably by a psychiatrist) according to DSM IV criteria or whether this is just a description. Luvox would be a good choice for OCD but is not commonly used first line for depression.

bpkurtz