Scared about medication symptoms

[J0HN_TIT0R]

Hey all,

So I was on zoloft for years when I was younger. I quite about 3 years ago because I began to get worried about the long term effects of being on an SSRI, even though I really wasn't experiencing any symptoms. I lost about 30 to 40 pounds since quitting, and for the first year or so I was doing OK. However, over the past year I've been having almost constant anxiety, with physical symptoms like headaches and lightheadedness, and It's gotten to the point where I decided to make a therapy appointment to try and work on these issues.

However, I know that one of the things we'll definitely be discussing will probably be medication. Last time I had therapy about two years ago I decided to not take any medication because I was nervous about side effects, particularly those involving memory, cognition, motivation, and as vein as it sounds weight gain. However, this time I am in a worse place, and may need to take medication...

Does anyone know of any good medications that don't have any of these worrying symptoms? The main reason I'm worried about these is because I'm worried it will make my grades slip if the symptoms are bad enough.

[panic_down_under]

So I was on zoloft for years when I was younger. I quite about 3 years ago because I began to get worried about the long term effects of being on an SSRI, even though I really wasn't experiencing any symptoms.

Many hundreds of thousand of people have taking SSRIs continually since they became available in the late 1980s without harm. I have been on very high doses of the older tricyclic class almost continually since March 1987 and they haven't adversely affected my health yet.

They may even be beneficial. Serotonergic antidepressants, for example, are mild anticoagulants which may reduce the risk of heart attack and ischemic stroke (though they may slightly increase risks for the much less common hemorrhagic stroke), may help the immune system fight some cancers, and may be protective against Alzheimer's and other dementias.

I was nervous about side effects, particularly those involving memory, cognition, motivation, and as vein as it sounds weight gain.

If anything, antidepressants should improve memory and cognition. They work by reversing the loss of neurons in the hippocampal regions of the brain which, among other things, mediate memory formation.

Antidepressants may reduce motivation, or perhaps more accurately, don't prevent that caused by the underlying disorder. It can usually be resolved by switching to a different med.

Weight gain can be an issue with all antidepressants and it may not all be down to a direct med effect. People who are no longer anxious, or depressed tend to begin enjoying food more so eat more.

Mirtazapine (Remeron) is the antidepressant which generally causes the most weight gain. The most likely SSRI to cause it is paroxetine (Paxil). Zoloft, Celexa (citalopram) and Lexapro (escitalopram) usually only cause modest weight gain, Luvox (fluvoxamine) tends to be weight neutral, and Prozac (fluoxetine) generally causes a small weight loss, though as with just about every aspect of antidepressants, YMMV.

If weight-gain becomes an issue with a SSRI supplementing it with low dose, <=75mg, of the stimulating antidepressant Wellbutrin (bupropion) may help. It may also counter other side-effects such as SSRI induced sexual dysfunction. Regular exercise would also help, both with weight gain and also anxiety/depression.

[GlassPinata]

I'd be cautious of Wellbutrin, though.
I tried it after Prozac made me gain weight. The Wellbutrin made me feel extremely weird and I couldn't sleep at all on it. i discontinued it after just a few days.
If it works for you, it is said to be one of the few antidepressants that don't cause weight gain (in fact, i couldn't eat at all when i was on it).

[panic_down_under]

The Wellbutrin made me feel extremely weird and I couldn't sleep at all on it.

Wellbutrin is by far the most stimulating antidepressant with Prozac a distant second. It is usually way too stimulating for most with anxiety disorders at therapeutic doses though some do well on it. However, most can tolerate doses up to 75mg/day.

[J0HN_TIT0R]

Do you think the loss of motivation and weight gain are due to just being happier? Like happy people may eat more for a variety of reasons. I'm wondering if I continue to eat the same amount of calories, should my weight stay constant? I think I'll need to go on something either way at this point, I just want to minimize side effects

[panic_down_under]

Like happy people may eat more for a variety of reasons. I'm wondering if I continue to eat the same amount of calories, should my weight stay constant?

Up to two thirds of people with anxiety disorders and/or depression are losing weight when they first seek treatment. They tend to regain the weight after treatment, and in some cases put on a few extra pounds/kilos.

Even if you put on weight this may be less of a health concern that leaving the stress driving the anxiety/depression untreated. Stress is by far the biggest cause of premature death as it can trigger many of the illnesses that take us out early including heart disease and cancers.

A 30 minute walk 4-5 days a week should help keep the weight down and also ease anxiety and depression. It triggers the same neurogenesis stimulation in the hippocampal regions of the brain as antidepressants and therapy do, albeit to a lesser extent. For mild anxiety/depression it may be all that's needed, especially when combined with Omega-3/fish oil supplements which also trigger hippocampal neurogenesis.

Fwiw, I was on the verge of pre diabetes a couple of years ago but on the advice of my doctor tried a high fat, moderate protein and low carb diet which has returned all my blood results to the low end of the normal range.