Posted by Dr. Beth Steinhauer on December 23, 2004, at 16:43:46
In reply to Steinhauer-Eating disorder and Depression, posted by iris2 on December 23, 2004, at 14:40:00
Dear Irene,
I am sorry that you have had such a difficult time. I am hopeful that you can find help for both your depression and for the bulimia.
You didn't mention which antipsychotic was tried, but some of the newer atypical antipsychotics have shown great promise in stabilizing mood disorders. Some, like olanzapine (Zyprexa) are known to cause weight gain quite commonly, but others, e.g. ziprasidone (Geodon) and possibly aripiprazole (Abilify), are less likely to cause weight gain. You may want to discuss this with your psychiatrist. Also, certain antioconvulsants can be very effective mood stabilizers. Lamotrigine (Lamictal) has antidepressant properties, and unlike Lithium and Depakote, does not cause weight gain. Electroconvulsive therapy is a VERY effective treatment for depression that is underutilized in this country, mostly because of mistaken impressions of what the treatment involves. (Many people have heard horror stories that are outdated; ECT did used to be a more barbaric treatment in the 1950s.) It is actually quite safe, alleviates depressive symptoms quickly, and can be administered on an inpatient or an outpatient basis. Certainly, your interstitial cystitis would not be a contraindication for ECT.
Apart from biological treatments, such as medicines and/or ECT, psychotherapy can be extremely helpful for both depression and bulimia. Cognitive-behavioral therapy has demonstrated effecacy for both conditions, and other talk therapies may be helpful, either alone or as in combination with medication/ECT.
I understand your concern about weight gain and bodily changes due to medications, and I don't share your family's views on this score...but it is possible that if you felt less depressed, you would be in a better position to manage any weight gain constructively, e.g. through increased activity and exercise.
Best of luck to you. ES
poster:Dr. Beth Steinhauer
thread:433391
URL: http://www.dr-bob.org/babble/eating/20041128/msgs/433443.html