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Probing The Mystery Of Paxil (Ssri) Weight Gain

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Why do so many people gain weight on SSRIs like Paxil? It's a question that's been bothering me for awhile and didn't make sense to me. In the course of my extensive reading in the area of health and weight loss, everything I've read leads to the conclusion that an increase in Serotonin curbs hunger and emotional eating. In fact, since going on Paxil myself I've lost weight and my cravings are greatly reduced. Yet when I research in the area of psychology all I hear is how SSRIs cause weight gain. Now, I finally came across a Psychology Today article that might shed some light on the issue.

According to a study by Judith Wurtman PhD, the people who gain weight on antidepressants are those who previously ate healthy, were normal weight, and enjoyed exercise. This makes sense to me since I was overweight, ate poorly, and hated exercise (and Paxil has reversed this in me). To me it implies perhaps those who react negatively to SSRIs have another chemical imbalance and would do better on another AD, although animal studies suggest that AD's may increase weight gain by interfering with other chemicals. The experts really don't know why. Also, other meds such as TCAs have noted weight gain as a side effect, so that shoots down my theory.

Here's where it gets interesting. What do you do when you gain a lot of weight on an AD? You probably start dieting, cutting calories. Carbs might be reduced. According to the article, carbs lead to serotonin increase (non-fructose carbs) -- but only when consumed without protein. They recommend eating non-fruit carbs alone, and that within an hour the craving to overeat should go away. So if you're cutting carbs and increasing protein to shed those medication-induced pounds, you might be doing the exact wrong thing. I find this info intriguing, and I'm definitely thinking of buying the book to read more about it. A lot of the new research in the area of weight control is starting to get into the area of hormones and other brain chemicals, and when I read those books I see so many parallels with my psychogical problems that it reinforces my belief that brain and body are interconnected, and you can't seperate one from the other in matters of psychological or physical health.

So if you have a problem with weight gain but your AD is otherwise working for you, this might be something to give a try. It's tough enough finding one that actually helps, that it's a shame to be forced to stop because of one side effect.

The name of the book in the article is: The Serotonin Power Diet: Eat Carbs -- Nature's Own Appetite Suppressant -- to Stop Emotional Overeating and Halt Antidepressant-Associated Weight Gain

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Great post man , Weight gain and antidepressants is a very controvercial subject and needs to be studied further.

Eating more vs not eating more , then we have the insulin resistance theory , carb or protein theory and such

Its so important because it leads to discontinuation of treatment , in some cases , or it can end up making you more depressed if your body image perception was already bad.

Personally a lower carb (not Atkins low by any means) diet whilst taking AD's helped me lose 70% of the weight i gained from a high carb diet.

Everyone is different , discontinuation due to weight gain sucks eitherway , and needs to be looked at further.

p.s did you ever get the book ?

Edited by madd0ctor

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Great post man , Weight gain and antidepressants is a very controvercial subject and needs to be studied further.

Eating more vs not eating more , then we have the insulin resistance theory , carb or protein theory and such

Its so important because it leads to discontinuation of treatment , in some cases , or it can end up making you more depressed if your body image perception was already bad.

Personally a lower carb (not Atkins low by any means) diet whilst taking AD's helped me lose 70% of the weight i gained from a high carb diet.

Everyone is different , discontinuation due to weight gain sucks eitherway , and needs to be looked at further.

p.s did you ever get the book ?

No, I never did get around to it yet. I've still got several books I haven't read yet waiting to be started. Too many books, too little time. Definitely a complicated issue. Glad you enjoyed the post.

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I know this is an older post, but do you mind telling me how many mgs. you are on? I have been on Celexa 20 mgs. on and off for several years and my doc just switched me to Paxil 10 mg. to start and we'll go from there depending on how I do on it. I have depression/Panic Disorder btw and have gained about 15 ils. since I quit smoking about a year and a half ago and worry this may cause more unwanted weight gain. :verysad3:

The celexa didn't seem to affect my weight at all,

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I know this is an older post, but do you mind telling me how many mgs. you are on? I have been on Celexa 20 mgs. on and off for several years and my doc just switched me to Paxil 10 mg. to start and we'll go from there depending on how I do on it. I have depression/Panic Disorder btw and have gained about 15 ils. since I quit smoking about a year and a half ago and worry this may cause more unwanted weight gain. :verysad3:

The celexa didn't seem to affect my weight at all,

Sorry I didn't respond sooner, I've been busy with work and haven't been around the forum for awhile. I hope you found the Paxil worked well for you! I'm on 37.5 mg of Paxil ER. Unfortunately, all that great weight loss and craving-disappearing stopped after almost a year on Paxil. Haven't been able to lose any more lbs. and I'm battling my sugar addiction again. Have no idea why. It's still working great for the depression though! Haven't done any further research on the issue yet either. I really should... my job is so demanding that I just never find the time.

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Thanks for responding! The paxil seems to be helping, maybe if I can stay on a low dose it won't affect my weight. I think I'm going to start walking a little around the neighborhood, I know that would help, plus it makes me feel better.

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I think everyone is different but I know the first SNRI I went on I lost weight. I'd take into consideration age group of the individual as well, activity level etc. I eat healthy but I'm getting older and my metabolism has slowed. I wouldn't myself blame just the AD for weight gain.

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Most of the people I've seen who started an SSRI gained weight, myself included. They do work for alot of people, but there are so many side effects. Best to address the cause in my opinion, which is dietary and energetic.

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My weight had been stable for a long period of time when I started taking SSRIs. The Celexa didn't seem to affect my appetite one way or the other, but was generally ineffective with the depression. Now that I've been on Paxil for 6 months or so, the weight gain is noticeable (~20 pounds or so), and doesn't seem to be slowing. It was unnoticeable at first because I was working out frequently, but now that I've transitioned to a "don't care to be around people for any reason" mode, I no longer visit the gym, and people are commenting on my rotundity. The craving for sweets is ever-present, and I make no effort to curb my daily intake. The Paxil has flattened me out emotionally, and blunted my impulse control to a certain extent, but I think the primary reason for my not wanting to moderate my sugar intake is because I'm spending so much time and energy fighting the inertia of the depression that I simply can't be bothered with one more task/prohibition. A self-serving schema certainly, but I'm exercising (no pun intended ) my right to be defiant, even if I'm beginning to look more like an Apatosaur than a human. :rock:

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Does weight gain from Paxil vary depending on the dosage taken? As an example, would someone on 60mg dose be more likely to gain more weight than someone on 20mg?

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From what I experienced, no. I'm on 60 mgs of Paxil and have not gained anymore weight from 30mg.

I also feel better on a higher dosage and exercise more frequently. If your AD is working, there's ways to get around the weight gain.

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Hi I'm on 20mg and I just started my first dose last night. I was just wondering, how soon does the weight gain start after you start taking paxil?

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I had been taking 30 paroxetine for many years, along with 45mg of mirtazapine.  As I have aged and am stable, my psych and I decided to wean me from paroxetine, which occurred between October 2015 and February 2016.  I still take the 45mg of mirtazapine. He reasoned that the mirtazapine would 'cover' my current needs without the paroxetine.  I have no negative effects from discontinuing the paroxetine.  

However, sometime in the last year or so, I have (without trying) lost 20 lbs, from 208 down to 197.  I had a complete physical checkup recently to see what may have caused the weight loss.  Nothing in the physical (blood work, chest xray, etc.) was amiss and nothing suggested the weight loss.  

My research on this suggests to me that the discontinuation of the paroxetine is the reason I have lost weight.  My reasoning started out fairly simply: if taking paroxetine causes weight gain, discontinuing it will likely result in a weight loss.  I am not complaining, just trying to find a cause for the weight loss.  

Others have reported a similar weight loss with discontinuing SSRI's.  http://survivingantidepressants.org/index.php?/topic/3552-weight-loss-getting-off-ssris/. In that reference, I found this statement:   Paxil shuts down the fat burning enzyme Leptin and after getting off of it, the enzyme awakens from a deep sleep and begins doing its job again.”

I have done some searching for the effect of ssri's, particularly paroxetine on leptin, and thus weight gain/loss and there is a lot of information about it.  At the moment, I am pretty much convinced that discontinuing the paroxetine has led to the weight loss.  

By the way, I am not complaining; 190 is a better weight for me than 207.  If anyone has additional info on this subject (paroxetine, leptin, weight gain/loss, etc), I would appreciate the information.  Thanks. 

 

 

Edited by retexan599

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21 hours ago, gentle sun said:

Wow, maybe I should think about switching to Mirtazapine.  Is this a ssri or something different?  How did you reduce your Paxil?

I was taking the 30 mg of paroxetine plus 45 mg of mirtazapine for many years, probably 10+ years. So, when I tapered off the paroxetine, the mirtazapine was already in place (there was no switch per se).  You can look up mirtazapine via google to see what it is.

We (my psych and I) tapered the paroxetine this way: Paroxetine: 10/6/2015 - 30mg -> 20mg; 11/24/2015 - 20mg -> 15mg; 12/14/2015 -15mg -> 10mg; 1/29/2016 -10mg -> 5mg; 2/25/2016 5mg -> zero.  All under psychiatrist supervision.  I have read that some people need to taper much more slowly.  

I should also add that I had been taking (and still take) 15mg of l-methylfolate (brand name Deplin) since 2014.  My doctor says that the Deplin helps the other medications cross the blood-brain barrier more efficiently.  I like it because since I started the Deplin, my anxiety is much less.  

 

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I will mention this to my doc.  Maybe mirtazapine will help me get off Paxil too.  And I could use something for anxiety so I will also mention Deplin.

 

If my Paxil is not working anymore, then stopping it shouldnt make any difference.  Wonder if it works that way.  Slowly though,.

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On 10/24/2016 at 4:30 PM, gentle sun said:

I will mention this to my doc.  Maybe mirtazapine will help me get off Paxil too.  And I could use something for anxiety so I will also mention Deplin.

 

If my Paxil is not working anymore, then stopping it shouldnt make any difference.  Wonder if it works that way.  Slowly though,.

If you do decide to discontinue your Paxil, (whether you think it is working or not) most sources will tell you to taper it very slowly, and not cold turkey. How slowly?  Lot of good info on the subject of tapering at: http://survivingantidepressants.org/.  

 

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On 10/26/2016 at 11:44 AM, retexan599 said:

If you do decide to discontinue your Paxil, (whether you think it is working or not) most sources will tell you to taper it very slowly, and not cold turkey. How slowly?  Lot of good info on the subject of tapering at: http://survivingantidepressants.org/.  

 

Thanks, Retaxan  You are right, I should know better!  Btw, good link!

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I took Paxil for six years until it suddenly stopped working.  I did not have the weight gain most people complain about while taking it.  I asked the doctor who prescribed it, why do people gain weight on it?  He said that it stimulates the hypothalmus which controls appetite.  My sister takes paxil and has gained an enormous amount of weight, HOWEVER, food has always been her stress reliever, so it's not just about the drug in her case.  I am not a doctor, but I would do exactly what you're doing--medical research, documenting peoples' responses, and considering all facets.  I'm one of those people who usually has the opposite response to a drug.  I've been on Wellbutrin for a while, and I'm the only person I know who gained weight in the first month or so. 

Bottom line, you really won't know how a drug affects you until you try something for at least three months. 

Best wishes -

WOTL

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Thank you for your post that was highly informative. No thank you to whomever runs this website, as my depression has just increased trying to get through the damn captcha puzzle to sign on here. LOL!It’s interesting you mention that people who are overweight before paxil for example, Will lose weight for being happier, while people such as myself who are mostly on the anxiety spectrum of depression, end up gaining weight. I eat enough fruit every night to feed an entire zoo. I didn’t know, nor do I crave, non-fruit carbohydrates The way I do fructose.

 

I simply thought that before the SSRI, my anxiety did not allow me to tolerate a few extra pounds. Being sort of an OCD thing, I figured the alleviation of whatever Imbalance caused this was just allowing me to take the extra pounds and not worry about it. And that was not the original intention of taking Paxil, As I would never allow myself to endanger my health really for any reason.

 

You have a theory, or one of your commenters mentioned, something about insulin intolerance. If that suggest that my body is not as well equipped to handle simple carbohydrates such as fruit, well that would explain everything, or at least a lot! I mean exercising now seems to have the opposite effect on me. I have a come far hungrier, especially for bulls*** like sweets, while at the same time my body craves more. I’m assuming this intolerance somehow tricks my body into thinking it needs more quick carbohydrates for some reason. While I have gained, I don’t know because I’m scared to weigh myself these days, probably 40 pounds making me statistically at least 50 pounds overweight.

 

Being 39 years of age and having a family history I have diabetes, this intolerance becomes highly relevant and even more highly scary.

 

I was starting to wonder if Wellbutrin  causes weight gain because I’m only on 10 mg of Paxil. But I think the Wellbutrin causes my body to crave simple glucose found in carbs and junk food.

 

I actually tried eating bread with olive oil and drinking milk this evening. Thanks to the rider and people who agreed that are carbohydrates such as bread and rice instead of fruit, candy, and soft drinks Will curb the desire for this junk.  This evening is the first time in a while where I’ve actually been able to resist the urge for fruit and a couple candy bars!

 

This post was extremely informative and I’m sure it has helped a lot of people! Hey seems fine now the medical community would know why SSRI medications typically causes weight gain, and what else could be taken instead. And idea I have would be CBD oil, because of its affect on the Endocannabinoid System which was just recently discovered by physicians in the 90s...

 

Mark V

http://SublingualMingle.com

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I gained weight from Paxil but I also exercise a lot too. So I can imagine not exercising would cause considerable gain. Been on 20 mg for several years. Went up to 30 before and it caused me to gain 15 pounds. 

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Paxil has been the very best AD for me ever.  But.. I did gain sooooo much unwanted weight-especially in the stomache.

I have done my own research too as well as gene test for psychotrophic meds.  One thingvI know is that paxil inhibits a particular enzyme pathway to use another enzyme pathway.  If that enzyme pathway is already functioning poorly as I found out mine is it causes toxicity on higher doses.  

I dont know if that relates to the weight gain or not. But it does create issues with the liver if that is the case which may contribute to thecweight gain.  Just a theory of mine.

I am have lost about 30 of the pounds I gained on it a few year back and stopped its last weaned dose nearly a year ago.  I miss the wellness I felt from it and after trying so many other meds I am almost ready to take the weight versus loss of life quality.

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