Posted by Elizabeth on April 9, 1999, at 6:28:59
In reply to Re: the weight gain issue, posted by JohnB on April 8, 1999, at 23:58:23
(Thanks to Dr. Bob for making a point that we sometimes forget. :-)
>An increase or decrease of, say, serotonin in certain parts of the brain my help mood symptoms but my play havoc with sites involved with appetitive or metabolic management. In most cases, weight gain is not caused by anything the patient can control completely; having an obscene sweet-tooth or overwhelming craving while on an MAOI or TRICYCLIC is as intense and all-consuming as the depressive symptoms being treated. This pharmacologically-triggered command to eat becomes real to many patients, and the literal slowing of metabolic processes make weight gain almost inevitable. Weight gain and its impact on health is not some frivolous concern. It's a genuine threat to human health that contributes to the chaos of a biological system out of balance, just as the torment of depression does.
Yes, I can identify with this. It happened to me on two drugs, Nardil and amoxapine (the amoxapine was in an MAOI-tricyclic combination, which may have made it worse - not sure). It felt like being addicted to food - I'm happy never to have had the experience of having been addicted to drugs, but I can imagine this is what it feels like. I was constantly thinking about food and having cravings for it.
The way this was explained to me is that whatever it is that tells you, "okay, we're full now" (mediated by the hypothalamus?) - i.e., the satiety response - is blocked by some of these drugs. I get the impression not much is known about this.
Apparently, some of the newer antidepressants can do this too; I've heard about it quite a lot with regard to Paxil (interestingly, one of the more "selective" serotonin reuptake inhibitors).
My psychopharmacology instructor (a wide-eyed research type) says he expects the next big revolution in pharmacology to be a new type of drug delivery system that allows you to target specific areas of the brain. (I'm not so sure about that, at least not until imaging studies (fMRI, etc.) are a lot less expensive and we have gotten more adept at interpreting the results, but it's an interesting idea nonetheless.)
poster:Elizabeth
thread:4030
URL: http://www.dr-bob.org/babble/19990401/msgs/4599.html