8 days into 0.5 mg of Rexulti and I've gained 7 lbs...

[CrazySoprano]

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Hello!

I've been away for quite some time, but here's a quick summary of my crazy:

I have major depressive disorder, dysthymia, and generalized anxiety disorder.  I've been in remission for about 10 years but had a relapse recently after two very sad overseas funerals, a visit to my parents (Dad has Alzheimer's, parents underwater on their mortgage, Mom probably has some undiagnosed mental health issue but refuses to seek treatment), and yet another close friend having a baby (husband doesn't want one, I do, we're working through it but it's pretty upsetting for me).

This ain't my first rodeo, so I did all the things we're supposed to do.  Went to my pdoc (had to get a new one because the old one didn't take HIPPA seriously enough for me), got a new tdoc, joined a new gym that's at the local hospital and includes nurse evals and sessions with a personal trainer every 6 weeks, found a dietitian, started doing more meditation, etc.

Meds going into this: 150 mg Wellbutrin XL, 5 mg Lexapro, 18 mg Concerta PRN, .5 mg Ativan PRN, Seasonale (awesome birth control pill where I get 4 periods a year)

Pdoc had me stop the Concerta, increase Wellbutrin to 300 mg, and add Rexulti.  I'm supposed to do 2 weeks at .5 mg (done one so far) and increase to 1 mg after that, come back in a month.

First 3 days of Rexulti I was incredibly sleepy.  I hoped that that would be a temporary side effect, and it was.  At this point, 1 week into the .5 mg of Rexulti, I am neither anxious nor depressed, but I weigh more than I ever have in my life and my clothes no longer fit.  Guys, I can't afford a new wardrobe.  I started this journey with a goal of losing 15-20 lbs.  Now, with the same goal weight, I have to lose 25-30 lbs.

I'm not overeating.  I'm doing everything the dietitian suggested.  I'm doing 40 min. of cardio 3-7 days a week. The depression kept me away from the gym for a while, but I'm getting back into it.

I'm going to try to get in to see the pdoc again next week, even though I'm supposed to wait until next month.  I'm really hoping that the weight gain will be temporary, but I have a sinking suspicion that it won't be.  I don't really want to stop the Rexulti because I feel better than I have in a long time, even before the most recent depressive episode, but I also really want to be at a healthy weight and be able to wear my clothes.

So, what do I ask?  Would increasing the Wellbutrin balance the weight gain effects of the Rexulti?  Would a weight loss medication help?  I had another pdoc suggest something like that when I was gaining weight on Prozac, but I ended up switching to another SSRI instead.

Thanks in advance!  Here's a picture of my puppy having an existential crisis:

[Iceberg]

Making all those changes at one time really muddies the waters. It could be a combo of adding rexulti (+ appetite and + weight) and dropping Concerta (lowers appetite). What about the lexapro? That's a low dose do u think bumping it would open up more options? Also, I kno one weight pill that actually uses bupropion, so idk that is causing the weight issue 

[browri]

@Iceberg is right. Might want to give it a chance to balance out. I personally didn't gain that much weight that fast on Rexulti. It could cause weight gain but after Wellbutrin ramps up to steady state again, it may offset that a bit. All-in-all those two changes seem to make sense to me to super-charge your existing cocktail instead of overhauling the whole thing.