Antidepressant Advice

Hi, I was looking for some advice re antidepressants... in June I “admitted defeat” and went to my GP regarding anxiety and depression that was affecting my every day life and he prescribed Citalopram 20mg. I took this for two months at varying doses (30mg and 10mg) and while it helped my anxiety, it left me feeling generally awful with unpleasant side effects so I asked to try something else. I was then put on Fluoxetine at varying doses, felt less awful than Citalopram but was very up and down still with horrendous carb craving which lead to overeating and weight gain, as well as loss of libido and excessive tiredness. I’m already obese and worked hard last year to lose 3 stone and was reluctant to put the weight back on again so asked my GP if I could try something else and have been put on Mirtazapine 30mg. I’ve been on this for a week and have gained half a stone already. I have PCOS so I do find I put weight on easily but having put on a total of 2 stone in the last three months I’m at the stage where I want to give up on ADs altogether. I’ve tried CBD oil and St Johns Wort as alternative remedies before with little effect. Does anyone have any advice? Should I keep trying despite not feeling like they’re helping me or just accept that I am better than I was without them and that I will balloon in weight which will only end up affecting my mood for the worse? My GP suggested I try walking to keep my weight down but I’m already doing more regular exercise than I ever was before as I have a dog now and go for two half hour walks a day, so horrified to think where my weight would be if I wasn’t doing that. I work full time in a sedentary desk job so not a lot I can do there. Any advice would be appreciated as I am at the end of my tether and not getting much feedback from GP.

[_Alex_]

Bupropion may be the best antidepressant for not gaining weight; however it could be very difficult to get prescribed in the UK outside of private doctors. The UK licence is only for smoking cessation so most doctors would refuse to give it. If you're in the US however I imagine you could get it.

Moclobemide may also not cause weight gain, and probably wouldn't cause sexual problems, and is known for being well tolerated. It's available in the UK, but it would depend on the particular GP, and the local area policy whether they would let you try it. Some areas you may need a psychiatrist to start treatment.

If you were worried about weight gain, they maybe shouldn't have used Mirtazapine as it's known to be a problem for some people on it.

[_Alex_]

Also, for carb craving, my experience is that giving up wheat makes a big difference. Not a nice prospect, because it's a big part of the Western diet, but that stuff is maybe more addictive than people realize.

[Smudge2522]

Hi kirenlouise, going to your GP for help whilst it might seem to be "admitting defeat" as you worded it definitely isn't it's you saying "I'm not giving up I just need some help" so is definitely something that takes courage. I do understand why you may think that as I've been down that thought road aswell. Im currently on fluoxetine after being on citalopram but so far not seeing much difference other than my appetite returning. It's great that you're doing plenty of walking and from the sounds of it you'll be achieving the 10000 steps (or at least getting very close) that personal trainers recommend hitting each day One thing I've been trying is to use my fitness Pal ,(mfp) to log everything I eat also helps me set calorie goals - I only use the free part of the app as don't see the need to pay for it. By logging everything I was surprised by how much I was eating and has been a real eye opener as some of the things I was eating were much higher in calories than I thought and that explained why I was gaining weight but since using mfp (and being 100% honest with it) I've managed to start losing the weight again. I think its worth a try especially in conjunction with the walking you're already doing. Keep up the hard work and the results should start showing for you.

Good luck

[Hidden]

Hi there, Citalopram worked for six months after started taking it. Had to move to Propanolol for last 12 months and zero panic attacks since. The depression comes and goes

[Robali]

Hi, over the course of 30+ years I’ve been on various antidepressants, most of them ssri’s including Citalopram, fluoxetine, sertraline & fluvoxamine. Citalopram worked best for me (I was much worse with fluoxetine & sertraline!), however a couple of months ago I went on to Mirtazipine as the ssri’s weren’t working for me and the side effects were bad (sertraline) and I think there is an improvement. It does take time and adjustment of doses unfortunately, before you find what is right for you, but don’t give up, you’ll get there.