Belly fat

[ShootingStarsinthesky]

I have had great emotional stability since being on Escitalopram 20mg and Amitriptyline 50mg daily over the past 4 years. This combination have enabled me to lead a good life with little anxiety or depression. However, sadly I have put on so much weight with this combo it is really getting me down and indeed getting worse and can't seem to lose more than a couple of pounds after great effort. The carbo cravings have always been tough but now I am fed up and a bit scared of this weight problem which is all around the belly and hips and hardly any on rest of body. I also have to drink a lot of liquid daily or else I get constipated and sweat with the slightest exertion. I also notice that I sweat after taking the Escitalopram in the mornings.

Rant over.. begrudgingly I feel I may have to change one or both of them (and most of us know how awful that can be!) and I have read that people have experienced weight gain problems on both but I am not sure where to start (obviously with GP) but which is more likely to be the culprit does anyone know or have experience of this??? please...

I don't know to be honest. I was on imipramine (a tricyclic like amitriptyline) for many years and didn't have any trouble with weight gain. Well I did but managed to lose 2 stone at SW and I don't think it was the meds to be honest. You are on very small doses - I hate to say this but are you absolutely sure it is the meds? I know how we can be in denial sometimes about food issues.

I am now on mirtazapine and that is a killer and weight gain is in the top 10 most common side effects. My appetite hasn't increased but they do apparently slow down metabolic rate and I have gained 1.5 stones and am heavier than I've ever been in my life, so I am considering gradually decreasing them because I don't think they improved my depression anyway. I am on Sertraline now and feeling so much better.

NO one can answer your question of which of the ADs is the "culprit" because as I'm sure you already know the drugs react differently on individuals as do the side effects - just to confuse us a bit more!

I don't know your background of course but are you certain it is the meds that have improved your emotional stability as they seem such small doses. Of course the only way you will know is if you reduced them - it's all so hit and miss isn't it. I have just been through a meds change and it was not pleasant and took much longer than I thought. If I were in your position I think I would stay on the meds - what's the point of being slimmer but mentally ill. A no brainer really!

Hi NanaNina,

Thanks for your reply. Sorry to hear you are heavier now. I know that all they tricyclics are infamous for their weight gain that and the risk of easy overdose are the reasons SRRI etc have been developed and overtaken them for use in depression. I am only on 50mg of Amitriptyline because it was given to me when Escitopram stopped me from sleeping through the night. A Psychiatrist I spoke to said that when it is used in conjunction with another antidepressant it has the power to work as a second antidepressant. I have also found it helps with migraine. I asked him if these drugs slow metabolism and increase appetite and he said they "do not slow metabolism but can make you hungrier, but you don't have to eat it". I guess he has never experienced the carbohydrate cravings that go along with these drugs! All GPs I have ever asked about weight gain say that people gain weight because they eat more when the depression is relieved and don't move around so much because they don't worry so much and are less worried about what they eat. I think they deny the weight gain element because most studies of why patients give up antidepressants are taken at the beginning of their treatment before their increased appetite has had a chance to evolve! So weight gain is not a top reason at that stage.

On sites I have read lots of people saying they put on weight with Escitalopram so that is part of the dilemma really which is the culprit??

I may just try and reduce the Amitriptyline down to 25mg if I can as it seems that less people seem to put weight on, on this dose. It's a maze.

Oh and by the way 20mg is the top dose for Escitalopram unlike Citalopram which I think can go up to 60mg.

I'm on two lots of meds. One has the side effects of lower metabolism, increased appetite and weight gain. The other has the side effect of weight gain.

The only way I've been able to keep the weight at bay is by exercising every day - not easy when you're depressed - and by being careful of what I eat, As soon as I stop, it piles on again.

I can sympathise with the cravings. If I don't fall asleep after taking my evening meds, I could clear out the kitchen like a locust, so have to take cares about when I take them. Self awareness plays a huge part.

Have you tried something like MyFitnessPal to track absolutely everything you're eating during the day? I used it when I first started gaining weight and it helped me keep an eye on things so I stayed under 2000 calories each day.

It is interesting to hear that you are on 2 meds KeemaNaanAndCurryOn and both of them can cause weight gain as well and you are succeeding in controlling your weight by watching you intake and exercising each day, well done.

I think one of the problems I have is that as my drugs are a bit sedating (I have anxiety as a problem more than depression) I have a limited amount of energy and start an exercising programme only to run out of steam within a few days. I know that sounds like an excuse but I do easily tire. Though saying that I am not working at the moment so although I have a car I incorporate a pretty long walk to the shops or cycle each day but the weight sticks. I think that I may need to try and cut down my night time drug Amitriptyline to from 50mg to 25mg if I can as this sedates a lot.

I have never linked taking my tablet at night and then having a desire for carbs within a short time afterwards and your comment 'I could clear out the kitchen like a locust' not only made me laugh but is something I will be more mindful about, thank you. I will also track food eaten throughout the day.

The cravings are pretty bad for carbs though and wonder what you do when the craving starts?

Just to add, I find that when I was working I could refuse all cakes, sweets and the endless food we had in our office but at home I only have to have a sniff of something sweet and I can eat and eat quite large amounts of sweet foods (which is something I don't remember doing before ADs). My husband laughs at me because I say don't let me go with food ie a meal because I actually feel quite stroppy if I don't eat very regularly. Am I self medicating with food??

Just wanted to add I deliberately do not have too many sweet treats at home mostly just for my husband (and I don't generally touch his treats) but can pig on anything remotely sweet and carbs of course.

One of my drugs, Quetiapine is very sedating. It's the one I have most problems with as I'm no use to anyone after taking it. It's also causes some muscle weakness, which doesn't help. At the moment it's taking a lot of effort as I put on a stone when I was in hospital as I couldn't get out and about and the food was incredibly stodgy. While I've not put any on since I came home, it's taking a long time to shift, at about 1/2 lb a week.

The only advice I can give really, is that if you want to reduce the amount of ADs that you're on, then I'd do it with the advice of your Dr, as it's best to reduce them in a controlled way.

Well done KeemaNaanAndCurryOn for starting to shift that stone you put on in hospital. I will take your advice and you take care. Thank you x

You could experiment with a different drug, I understand your reluctance though if they are working.

I haven't taken those meds, but I have been on other meds which cause weight gain, and gain it I did. The doctor actually told me it would be impossible to lose the weight while still on it. He was wrong as it turned out though. It can be done, but takes rigid control of food intake. It means you have to really be on a constant diet intake just to avoid gain, and that you lose weight a bit more slowly. I didn't exercise really, due to physical problems at the time. I'm now off that drug as it was so easy to regain weight and as I realised it wasn't really helping me much.

So I think the best thing you can do is see if you can manage to get things under control - it may not take as much reduction in food as you fear. If not, it will be a choice whether to tolerate the weight or very carefully try a different drug. I am on Sertraline and have not gained any weight on it so far.