The whole truth revealed

Hi, so I went to see my doctor today to talk with her about how my depression meds do not seem to be working as well as they once did.  I was taking Fluoxetine (generic Prozac) 40mg, up from 20mg when I was originally prescribed them back in 2007.  After some talking, some crying, and some reassurance from the doctor, I have agreed to start on Cymbalta to see if this will help me better.  I'm a bit scared though because I have to go off the Prozac for a few days to do a "wash out" which essentially means cleaning as much of the med out of my system as I can prior to beginning the Cymbalta.  The doctor said to expect some lightheadedness, some increased teariness, and some elevated emotional reactions.  Yippee!  :(  It is only for a few days right? 

So, I said in the title of this post that I was going to reveal the whole truth.  And here it is in black and white.

Weight:  294 pounds (that is up 9 pounds since I last weighed Sept 5 and 20 pounds since my last physical in early 2007!)  OMG I cannot believe that I have gained that much weight!  I know it is because I started to lose the weight and then yo-yo'd back plus some.

BP: 146/90 and this is on my blood pressure meds which normally keep my bp down at normal 120/80.  She is going to reexamine things in November when I go in for my annual physical.

Motivation:  None or very little prior to my appointment, yet increasing every moment since.

I talked with her about my weight concerns.  She explained to me how we need good levels of seratonin in our system in order to regulate our moods.  Those of us who suffer from depression (a chemical imbalance in the brain) are low on the seratonin.  Studies have shown that there are actually certain "comfort foods" which help produce seratonin, which is why we feel better after consuming them--foods like chocolate, carbs, etc.  Diets like Atkins and others which promote low or no carbs, actually find people with an increased incidence of depression.  They have found that even eating just one small square of chocolate prior to a meal decreases the amount of food a person ate.  She told me that for me personally, it really isn't about willpower.  It is about my hormones and brain chemicals being all out of whack.  And so we have a plan now to get things organized again, which should result in my being able to actually LOSE and keep it off!

For the first time in forever, I feel the hope.  More to come as time goes on.  :)

((hugs))

She is right.  You are 'self medicating' and once you get your official meds sorted you won't need to any more!

((hugs))

(((more hugs)))

I am sorry that you have been feeling down and that your are having trouble with results from your meds but the future sounds really hopeful and your doctor seems committed to helping find a solution.  I really like the way she explained the link between over eatting and lack of motivation to whats going on chemically in your body.  It seems so logical once you hear it   I know together you will find a solution that works long term!

anti-depressant crap shoot

I don't mean to sound antagonistic, I've just done a lot of reading about serotonin and medications that affect it.

The truth is: scientists and doctors do not know why people get depressed.  They think it has something to do with neurotransmitters, serotonin being one, dopamine and norepinephrine being two others.

If low serotonin is your problem, then the Prozac should be working for you as it is a serotonin reuptake inhibitor (SSRI) and therefore increases the amount of free serotonin in the neuron synapses.

Cymbalta on the other hand works primarily as a norepinephrine reuptake inhibitor (SNRI), though I think it acts weakly as SSRI as well.  If low serotonin is your problem, then Cymbalta will not raise the level of serotonin nearly as well as Prozac will.

Anti-depressants are really a crap shoot.  Nobody really knows what causes depression, so how can anyone know what drugs will be effective ?  Do you have low serotonin or low norepineprhine ?  Maybe you have low dopamine ?  Do acny doctors ever actually test to find out what your levels are ?  Of course not.  They just prescribe pills.  When one doesn't work, they try another, and another, and another ...

You might want to consider going off anti-depressants entirely.  Your brain and body chemistry are not static.  You're already on the right track losing weight, you're probably eating better and getting more exercise, feeling better as a result, hopefully sleeping better, and even just having a more positive and optimistic outlook .... I think you can go a long way through non-drug means.