Posted by fachad on March 22, 2002, at 8:19:18
In reply to Remeron, Zyprexa and weight gain:, posted by Janelle on March 22, 2002, at 2:32:30
I have spent more time trying to figure that out than on any other subject in this whole PSB domain! That's how I became familiar with different classes of meds, different receptors, affinities, etc.
It's been about 10 years of research, and I can say with confidence that nobody really knows for sure, and it seems to vary from person to person.
For a while pdocs were saying that the weight gain was a natural part of relieving the depression and re-gaining the weight that was lost due to depression.
But obviously some people who were weight normal before depression became severely obese during treatment.
The next round of explanation was that these drugs stimulated the appetite thru blockade of H1 histamine receptors. People ate more, therefore they gained weight.
But SOME patients gained a disproportionate amount of weight - more than could be explained by the extra food they were eating. So some mechanism of changing the way the body burned calories was proposed.
So although there are a million theories, there is no real way to accurately predict whether or not a certain drug will cause weight gain in a particular individual.
From my own personal experience, doxepin (an antihistamic TCA) causes weight gain even if I take very small doses (<10 mg/day) and even if I both EAT LESS and EXERCIZE MORE I still gain weight. I have kept food and activity journals over time both with and without doxepin, and for me, doxepin both increases my appetite and slows down my metabolism. Even when I resist the desire to eat more, plus work out more, I still pork out.
Others have reported increased appetite, increased eating, but no weight gain.
And some say they did not have increased appetite, but still had weight gain.
Some, like you, report that they had increased appetite, but did not eat more, and did not gain weight.
So it's a question that does NOT have a simple answer, or even a complicated answer that is applicable to everyone. It is a question that looms big in everyone’s mind.
> What is the mechanism by which Remeron and Zyprexa cause weight gain? Is it that they stimulate appetite, so you're more hungry, you then eat more and thereby gain weight, or is it that they slow down your metabolism so even if you do NOT eat more you still gain weight?
>
> Actually, I have experience with Zyprexa and for me it was a case of appetite increase - I was hungrier but I resisted the cravings and munchies and didn't gain any weight. Luckily, the increased appetite side effect wore off fairly soon.
>
> Thanks to whoever can explain why/how Remeron, Zyprexa and who knows what other meds, can cause weight gain.
poster:fachad
thread:99410
URL: http://www.dr-bob.org/babble/20020322/msgs/99449.html