[riseandshine]

I've been around the med-go-round many times. I've been prescribed Anafranil (a tricyclic AD), but am too fearful of potential weight gain to start it. It takes A LOT for me to let go of my fear and start a new medication. Unless a drug is reputed as being weight neutral, it usually takes an extended period of absolute desperation for me to finally give it a go. I reallize my fear is quite irrational, but I have an eating disorder and major insecurities when it comes to my weight (obviously). I'm just wondering if anyone has any helpful advice. Is weight gain inevitable on an older AD? Does anyone want to smack some sense into me ?

I apologize if this sounds vain or immature. To me, this fear is very REAL.

Thanks for reading.

[bluelikejazz]

I'm on a high dose of amitryptaline (another TCA) and I haven't gained any weight at all; and it's worked better than any other meds that I've tried yet.

[null0trooper]

riseandshine, on 18 November 2009 - 02:54 AM, said:

I'm just wondering if anyone has any helpful advice.

Pretend that it will cause you to gain a little weight and use that as an excuse to do cardio
3 times a week (and not to skip it if you already do )

riseandshine, on 18 November 2009 - 02:54 AM, said:

Is weight gain inevitable on an older AD?

The sad truth is that if it were, the AIDS and cancer treatment communities would be all over it (wasting is a serious, and heartbreaking thing.) RxList lists weight gain as only as miscellaneous side effect, slightly more likely with Anafranil than placebo. You have a low chance of gaining weight, but are far more likely to maintain your weight.

On the brain chemical side of things, Ananfranil is believed to affect mostly serotonin somehow. I'm on desipramine (noradrenaline reuptake inhibitor,) which carries a risk of weight gain or loss. It's the strongly antihistamine TCAs are the ones noted for causing weight gain, and I can't see your doctor wanting you on one of those.


If that's confusing, it's because "TCA" only refers to compounds with a certain structural quirk that someone's been using as an antidepressant. Few, if any, of them actually work alike.

[Anna]

Also keep in mind that you can stop the med. TCAs have a bit of a reputation, but I've seen plenty of folks NOT gain weight on them. If it makes you feel any better, ED pts, in general, are less likely to gain weight on the traditionallly "weight gaining" meds, than the general population..... There are various theories about why that is, in the ED tx community, floating around, but the bottom line is that you may do just fine on it. Particularly if you stay aware, etc., and work on good nutrition and exercise.

And, worst case scenario, if you find it to be a real problem, there are other options. If there's one thing ED pts know how to do, it's lose weight. I'm totally not trying to be flippant, just pointing out that if there's a bit of weight gain and it's really freaking you out, you can stop the med, and work on getting back to a healthy baseline fairly easily, probably (this is all based on the hope that your behaviors are more healthy at the moment, and that it wouldn't trigger you into an episode, etc. If not, you may need to talk further with your doc, etc. But perhaps you can put in plan a place where, if you say, gain more than X number of pounds, you discuss with your doc stopping the med ahead of time, etc. That might help you feel more in control with it.....)

Anna

[null0trooper]

Anna, on 18 November 2009 - 09:25 AM, said:

But perhaps you can put in plan a place where, if you say, gain more than X number of pounds, you discuss with your doc stopping the med ahead of time, etc. That might help you feel more in control with it.....)

Anna

That's a good suggestion - and it would be useful for a lot of people who are worried about the possibility of weight gain.

[riseandshine]

Thanks so much for the input. I really appreciate the feedback and the effort to understand my concern/fear.

I'm giving the med a try, and today is day 2. I'm a little stuck in panic-mode, but that's ok. You are all correct- not everyone experiences every side effect, and I can always stop taking it if the costs outweigh the benefits.

Thanks again for the nudge in the right direction