Why does zoloft cause weight gain. Understanding Zoloft Weight Gain: Causes and Solutions for SSRI-Related Weight Changes

07.11.197320.09.2021 by alexxlab

Why do SSRIs like Zoloft cause weight gain. How much weight gain is typical with SSRI use. What are the potential mechanisms behind SSRI-induced weight changes. How can patients manage weight while taking SSRIs for depression.

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The Link Between SSRIs and Weight Gain

Selective serotonin reuptake inhibitors (SSRIs) like Zoloft (sertraline) are a widely prescribed class of antidepressants. While effective for treating depression, SSRIs can come with side effects, including potential weight gain for some patients. Understanding this connection is crucial for those taking or considering SSRI treatment.

How Common is Weight Gain with SSRIs?

Research indicates that weight gain associated with SSRI use is typically modest. However, the impact varies between individuals. For some, even a small weight increase can be concerning, especially when balancing the benefits of improved mental health with changes in physical appearance or health.

Mechanisms Behind SSRI-Induced Weight Gain

The exact reasons why SSRIs may lead to weight gain are not fully understood, but several theories exist:

Metabolic changes: SSRIs might alter how the body processes and uses calories.
Appetite increases: Some patients report increased hunger or food cravings while on SSRIs.
Recovery of appetite: Depression often suppresses appetite, and as patients improve, normal eating patterns may return, leading to weight gain.

Do All SSRIs Cause the Same Amount of Weight Gain?

Not all SSRIs are equal when it comes to weight gain. Studies suggest that paroxetine may be more likely to cause weight gain compared to sertraline or fluoxetine. This variability highlights the importance of individualized treatment approaches.

Managing Weight While Taking SSRIs

If you’re experiencing unwanted weight gain while on an SSRI, it’s crucial not to discontinue your medication without consulting your healthcare provider. Abrupt cessation can lead to discontinuation syndrome, a set of potentially distressing withdrawal symptoms. Instead, consider these strategies:

Mindful Eating Practices

Adopting mindful eating habits can help mitigate weight gain. This might involve:

Paying attention to portion sizes
Eating slowly and savoring each bite
Being aware of hunger and fullness cues
Choosing nutrient-dense foods over empty calories

Increasing Physical Activity

Regular exercise can help offset potential weight gain and has the added benefit of boosting mood. Consider:

Finding an enjoyable form of exercise
Setting realistic fitness goals
Incorporating movement into daily routines
Gradually increasing activity levels

Alternative Medication Options

If weight gain persists as a significant concern, discuss alternative options with your healthcare provider. They may suggest:

Switching to a different SSRI with potentially less impact on weight
Trying a non-SSRI antidepressant like Wellbutrin (bupropion), which may be associated with slight weight loss in some patients
Adjusting dosage or combining medications to find the right balance

The Role of Nutrition in Managing SSRI-Related Weight Gain

A balanced diet plays a crucial role in managing weight while on SSRIs. Consider the following nutritional strategies:

Balanced Macronutrient Intake

Ensuring a proper balance of proteins, carbohydrates, and healthy fats can help regulate appetite and energy levels. Focus on:

Lean proteins (e.g., chicken, fish, legumes)
Complex carbohydrates (e.g., whole grains, vegetables)
Healthy fats (e.g., avocados, nuts, olive oil)

Mindful Snacking

If SSRIs increase your appetite, choose nutrient-dense snacks to satisfy hunger without excess calories. Options include:

Fresh fruits and vegetables
Greek yogurt with berries
Hummus with carrot sticks
A small handful of unsalted nuts

The Importance of Regular Monitoring and Communication

Maintaining open communication with your healthcare provider is essential when managing SSRI-related weight changes. Regular check-ins allow for:

Tracking weight changes over time
Adjusting treatment plans as needed
Addressing concerns promptly
Exploring additional support options (e.g., referral to a nutritionist or fitness professional)

How Often Should Weight Be Monitored?

The frequency of weight monitoring may vary based on individual needs and concerns. Generally, monthly weigh-ins can provide a good balance between tracking changes and avoiding obsessive behaviors. Discuss the appropriate monitoring schedule with your healthcare provider.

Psychological Aspects of Weight Changes During SSRI Treatment

Weight changes during antidepressant treatment can have psychological impacts that are important to address. Consider the following aspects:

Body Image and Self-Esteem

Weight gain may affect body image and self-esteem, potentially impacting the overall effectiveness of depression treatment. It’s crucial to:

Practice self-compassion
Focus on overall health rather than just numbers on a scale
Seek support from mental health professionals if body image concerns arise

Balancing Mental Health and Physical Health Goals

Finding a balance between managing depression symptoms and maintaining a healthy weight is key. This may involve:

Setting realistic expectations for both mental and physical health
Recognizing the importance of mental well-being in overall health
Developing a holistic approach to health that addresses both mind and body

Long-Term Considerations for SSRI Use and Weight Management

When considering long-term SSRI use, it’s important to think about sustainable weight management strategies. This may include:

Lifestyle Modifications

Adopting long-term lifestyle changes can help maintain a healthy weight while continuing SSRI treatment. Consider:

Developing a consistent exercise routine
Creating sustainable, healthy eating habits
Managing stress through techniques like meditation or yoga
Prioritizing adequate sleep and rest

Regular Health Check-ups

Ongoing medical supervision is crucial for long-term SSRI use. Regular check-ups allow for:

Monitoring overall health markers beyond just weight
Assessing the continued need for antidepressant medication
Adjusting treatment plans based on changing health needs
Addressing any emerging side effects or concerns

Understanding the relationship between SSRIs like Zoloft and weight gain empowers patients to make informed decisions about their mental health treatment. By implementing targeted strategies and maintaining open communication with healthcare providers, it’s possible to effectively manage both depression symptoms and weight concerns. Remember, the goal is overall well-being, balancing mental health improvements with physical health maintenance.

Why SSRIs Cause Weight Gain and What to Do About It

Like any medication, antidepressants in the class of selective serotonin reuptake inhibitors (SSRIs) have potential side effects. For some people who take an SSRI, such as Prozac (fluoxetine) or Zoloft (sertraline), one of these is weight gain.

Research suggests that the amount of weight typically gained while on an SSRI is modest. Even so, while a few extra pounds may seem like a small sacrifice to make in exchange for feeling mentally clear and emotionally stable, not everyone who has to move up a notch on their belt is OK with having to do that.

Why SSRIs Causes Weight Gain

Experts aren’t certain why SSRIs have the potential to put pounds on folks who take them, but there are some theories. It may be the drugs trigger changes in metabolism that cause the body to use up calories less efficiently, or that they affect the appetite, leading a person to overeat.

Another hypothesis is that weight gained while on an SSRI may be partially due to the fact that some people don’t feel like eating when they’re depressed and so they lose weight.

Once they start feeling better while on medication, their appetite comes back, they eat more and eventually return to their regular weight. In this case, yes, they’ve added a few pounds to the scale, but only enough to get them back to normal, not to an unhealthy state of being overweight.

Managing Your Weight While Taking SSRIs

Let’s say you’re among the unlucky folks who’ve gained weight while taking an antidepressant. If this really bothers you, you may be tempted to pour your pills down the drain. Before you do that, though, talk to your doctor. In all likelihood, you can get back to your happy weight without sacrificing your overall happiness.

Besides, it’s dangerous to just stop taking an antidepressant: With many of them, going cold turkey can lead to an array of unpleasant withdrawal side effects known collectively as discontinuation syndrome. Here are other, less drastic, measures you can take to lose weight while on an antidepressant.

Mindful Eating

Ask your doctor to refer you to a nutritionist who can help you figure out what your goal weight should be and what sorts of changes you need to make to your eating style to get there. It may be something as simple as giving up your daily soda, cooking for yourself at home more often, or being more mindful of your eating behaviors (slowing down while eating or eating at different times, for instance).

Increasing Activity

Adding activity into your daily routine, especially while being mindful of your eating and food intake, will help tip the scale back in your favor more quickly. Join a gym, get a dog (folks who have one tend to walk more and weigh less than others, plus being around animals has been shown to help with depression), take up a sport, climb around on the jungle gym with your kids.

If you’re new to exercise, check with your doctor before you lace on those sneakers though, just to make sure you don’t overdo it at first.

Switch Medications

Although most antidepressants potentially cause weight gain, this is more of a risk with some than others. Research suggests that paroxetine is linked to more weight gain than sertraline or fluoxetine.

It’s possible your doctor will be able to prescribe a new SSRI that doesn’t make you put on pounds, or he may have you try a non-SSRI such as Wellbutrin (bupropion), an antidepressant that’s a norepinephrine-dopamine reuptake inhibitor (NDRI). It works differently in the brain than SSRIs do. Some people even lose a little weight while taking Wellbutrin.

Celexa (Citalopram) and Weight Gain

Nearly all antidepressants have the potential side effect of causing weight gain—including Celexa (citalopram), a selective serotonin reuptake inhibitor (SSRI) similar to Prozac (fluoxetine) or Zoloft (sertraline).

Even though research shows that in general, the amount of weight a person is likely to put on while taking Celexa or another SSRI tends to be minimal, for some folks seeing their weight creep up even a little bit can be bothersome. If you’re one of them, it may be helpful to know that there are commonsense ways of dealing with weight gain while taking Celexa.

Why SSRIs Like Celexa Cause Weight Gain

Experts aren’t certain why SSRIs have the potential to put pounds on folks who take them. One theory is the drugs somehow affect the body’s metabolism so that it burns calories more slowly. Another is that SSRI’s trigger an upsurge in appetite, causing a person to overeat.

Another hypothesis why some folks gain weight while on an SSRI is that for them, depression is an appetite-killer: When they’re feeling low they don’t eat and therefore lose weight. Once they begin taking medication that makes them feel better, their interest in food returns and they start to eat more and, naturally, put on some pounds. Sure they gain weight, but it may just be enough to return to their normal weight—not to surpass a healthy number on the scale.

How to Lose the Extra Weight

If you’ve gained weight while taking Celexa and it’s enough to bother you—despite whether the medication is relieving your depression symptoms or not—talk to your doctor. Managing your weight while on an antidepressant really isn’t that different from doing so when you aren’t. Just don’t stop taking the drug. Going cold turkey off an SSRI can lead to discontinuation syndrome, an array of unpleasant withdrawal symptoms. Here are other, less drastic, measures you can take to lose weight while on an antidepressant.

Eat less. Notice where extra calories may be sneaking into your diet. Some typical culprits are soda and sugary carbs. Simply giving up these things or cutting back may be enough to help you lose weight. Your doctor can refer you to a nutritionist if you need help figuring out how to alter your daily diet.
Move more. Join a gym or exercise class, invest in a snazzy new bike, or get a dog—there’s research showing that people who have one tend to get more exercise and be happier. Remember that besides burning calories, exercise can help to ease depression as well, so with this tactic, you get a twofer. If you’re new to exercise, check with your doctor before you start just to make sure you’re physically up to it.
Change your medication. Weight gain is more likely with some antidepressants than others. It’s possible your doctor will be able to prescribe a new SSRI that doesn’t make you put on pounds, or he may have you try a non-SSRI such as Wellbutrin (bupropion).

A Word From Verywell

If you are concerned that you’ve gained excessive weight while taking Celexa and haven’t been able to lose it on your own, talk to your doctor about the issue. It’s possible that you can switch to a different medication with fewer weight-related side effects.

Losing Weight Gained From Mood Disorder Medications

One of the common challenges faced by people with mood disorders is weight gain from their medications—many people who take certain newer antipsychotic medications may experience significant weight gain as a side effect. This weight gain is believed to be caused by an increased appetite for foods high in carbohydrates and fat as well as these medications’ impact on metabolism.

In addition to being physically dangerous, extra weight can be a stumbling block to good mental health if it affects your self-esteem and comfort in your own body. To make matters worse, weight loss while still taking the medications that caused the initial gain can be notoriously difficult. But there is hope.

Medications That May Cause Weight Gain

Many medications used in the treatment of mood disorders list weight gain as a potential side effect, including:

Clozaril (clozapine)
Depakene (valproic acid)
Depakote (divalproex sodium)
Lithobid (lithium)
Paxil (paroxetine)
Remeron (mirtazapine)
Risperdal (risperidone)
Seroquel (quetiapine)
Tegretol and Equetro (carbamazepine)
Zyprexa (olanzapine)

Research on Medication-Induced Weight Gain

A presentation by Dr. Rohan Ganguli and Nurse Practitioner Betty Vreeland, related to their 2007 article published in The Journal of Clinical Psychiatry, focused on the issue of weight gain and medications.

Dr. Ganguli began by saying he had treated many psychiatric patients for years without really thinking about their weight. Then a colleague did a survey that found that of their patients diagnosed with schizophrenia, less than 20% were in the normal weight range, and 60% were considered obese.

Dr. Rohan Ganguli said that, unfortunately, “it has been assumed that people with schizophrenia are socially unaware and that, unlike the rest of us, [their weight] really does not matter to them.” Yet when they asked these patients how they felt about their weight, a majority of the overweight and obese patients said they wanted and had tried to lose weight.

Dr. Ganguli and his fellows developed a program that clinicians could easily provide to their patients. It involved 14 weeks of group sessions with training in areas including developing healthy eating habits, burning more calories, and changing snacking habits. Self-monitoring in the form of daily weighing and food and exercise logs was key.

Study Results

The results after the 14-week program were very encouraging: Two-thirds of patients lost at least 3% of body weight and around 40% of participants lost 5% of their body weight or more.

In addition to promoting key lifestyle changes in a supportive, collaborative environment, the program also focused on counteracting common thoughts, such as those surrounding the concept of “wasting” food.

A key part of the program’s strategy was teaching people that it was OK not to eat the entire meal.

Research to Prevent Weight Gain

Finally, they tested the program with patients who were just starting on some of the medications that are known to cause weight gain, including Seroquel (quetiapine), Risperdal (risperidone), Clozaril (clozapine), and Zyprexa (olanzapine). In all cases, intervention prevented weight gain in more patients than in the control group, although the success rate depended on the medication.

In this small study, the most dramatic difference was with Seroquel, where more than 60% of the control group gained significant weight, compared to only 10% of those in the intervention group who gained.

Lifestyle Barriers and Interventions

A unique set of challenges exists for those with psychiatric disorders that might not in other populations, including the metabolic effects of their medications, the impact of symptoms on motivation, poor dietary habits, and high rates of sedentary behavior.

For example, Ganguli and his team found that many people with schizophrenia eat at fast-food restaurants because these are inexpensive and convenient, but these meals are often high in calories and low in nutritional value. Chronic poverty can also be a factor for those with mental illness, which affects the quality of life, self-esteem, and the ability to pursue “leisure” activities such as participating in exercise.

A meta-analysis of 17 studies and nearly 2,000 participants looked at successful lifestyle interventions for those living with serious mental illness. The study found that programs of at least a year’s duration had more consistent outcomes.

Some of these interventions included physical activity, nutritional advice, behavioral programs, and access to free fruits and vegetables. Successful outcomes included improved blood pressure, weight loss, BMI reduction, smaller waist circumference, and lower cholesterol.

Individualizing Mental Health Care

Mental health practitioners of all kinds owe it to their patients to compassionately address the problem of medication-induced weight gain and recognize that their patients do care.

Ganguli and Vreeland’s work shows that while people living with mental health disorders face unique challenges, they are not only capable of making healthy lifestyle changes and losing weight but are often motivated with the right support.

A doctor who instructs their patient to simply “join Weight Watchers” to combat weight gain may not realize that some people aren’t up for going to meetings when depressed and that some just aren’t “group” people.

A therapy group with people who have gained weight because of their psychotropic medications might, on the other hand, be helpful. It’ll be important for providers to take the time to individualize their approach.

A Word From Verywell

Losing weight while on psychotropic medications isn’t fast or easy. Although it may be difficult, take encouragement from knowing there is solid research to show it is possible to lose weight, and still take your medication. If you’re concerned about weight gain caused by the medication you take, consult with your healthcare provider to develop a plan that will work for you.

Are My Antidepressants Making Me Gain Weight I Banner Health

For millions of Americans suffering from certain types of mood disorders, such as depression, antidepressant medications can be helpful—even lifesaving. But for roughly 25% of people who take these medications, it could also mean some unexpected pounds, which isn’t so helpful for those watching their weight.

We asked Gagandeep Singh, MD, a psychiatrist at Banner Behavioral Health Hospital, to explain why certain antidepressants can cause weight gain.

“While we don’t fully understand why antidepressants lead to weight gain, there are confounding factors,” Dr. Singh said. “The first is that not all antidepressants are alike. Some can trigger changes in the brain that affect appetite and metabolism. The second is that weight gain can be impacted by a person’s lifestyle and diet.”

For example, when people are depressed, their appetites change. Some people will forgo food in a state of depression, while others overeat. When placed on an antidepressant, their usual appetites could change, for better or worse, and impact their waistline.

Types of Antidepressants That Could Cause Weight Gain

Dr. Singh explained that some antidepressant medications are more likely to lead to weight gain than others, including:

Selective Serotonin Reuptake Inhibitors (SSRIs)

Brand names include: Celexa, Lexapro, Prozac, Zoloft, and Paxil

Risk of weight gain: With this type of medication, usually there is a drop in weight early, but long-term, those on SSRIs have experienced mild weight gain. Amongst these medications, Dr. Singh said those that contain paroxetine usually cause the most amount of weight gain.

Selective-norepinephrine Reuptake Inhibitors (SNRIs)

Brand names include: Cymbalta and Effexor

Risk for weight gain: Among the SNRIs used to treat depression, people usually experience transient weight loss and don’t see much weight gain.

Tricyclic Antidepressants (TCAs)

Brand names include: Pamelor, Elavil, and Vivactil

Risk of weight gain: TCAs are some of the earliest forms of antidepressants and aren’t as commonly prescribed today because they can cause more side effects, including weight gain.

Atypical Antidepressant – Mirtazapine

Risk of weight gain: This drug has been linked to both increased appetite and weight gain. “Most often we use this side effect to our advantage with patients who have stopped eating,” Dr. Singh said.

Don’t Stop Cold Turkey on Your Meds

Your medication is being prescribed for a reason, so don’t stop your medication cold turkey if you are experiencing weight gain or other negative side effects. Antidepressants help balance chemicals called neurotransmitters in your brain, and abruptly stopping can trigger some negative discontinuation symptoms. More importantly, the underlying symptoms can come back, which can be life-threatening.

“While antidepressants aren’t addictive, if you suddenly stop them, you can have discontinuation reactions such as flu-like symptoms, insomnia and returning thoughts of suicide,” Dr. Singh said. “Symptoms can vary person-to-person, so talk to your doctor and don’t take a gamble on your health. Remember finding the right treatment may take trial and error and some modification.”

Tips to Avoid the Extra Pounds

Eat right. This means integrating more fruits and vegetables into your diet and reducing your intake of high fat, sugary, or processed foods. Look for lean animal-based proteins, such as fish and chicken.
Get moving. Adding just a little bit of activity into your daily routine can help burn calories and improve your overall mindset. Join a gym, go hiking, sign up for a race or walk your local mall. “I tell patients starting antidepressants to try and walk a mile three times a week or more,” Dr. Singh said. “Just that little level of activity can affect mood and weight.” Don’t forget mind-body exercises, such as yoga, that help reduce any stress which may be contributing to overeating. All these things can help tip the scale in your favor.
Keep a healthy routine. Make sure you are getting plenty of sleep and stay away from drugs, alcohol, and nicotine, which can worsen depression and anxiety symptoms.
Talk to your doctor. No single medication works for everyone. If you are noticing negative side effects or reactions, such as weight gain, talk to your doctor. They can see if adjusting dosage or switching to another antidepressant helps.

Bottom Line

While some antidepressants can lead to added pounds, they are highly effective treatments for those suffering from certain mood disorders. If you are noticing weight gain, speak with your doctor sooner rather than later, so they can help you. To find a doctor near you who specializes in mood disorders, visit bannerhealth.com.

For more information on the symptoms of depression, visit Steps for Seeking Help for Symptoms of Depression.

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A Diet to Manage Sertraline (Zoloft)-Induced Weight Gain

The statistics about depression are staggering. If you’re living in a 50-unit apartment building, at least 10 women and more than 5 men probably have depression¹. And the alarming fact is that it’s increasing².

It’s understandable then, that one of the most prescribed drugs in the US is an antidepressant. Called sertraline (trade name: Zoloft), in 2018 it was the 14th overall most commonly prescribed drug, more than insulin, Ambien, or Xanax³. In fact, in 2018, there were 48,999,022 prescriptions for Zoloft⁴.

While antidepressants can be tremendously helpful for depression, one important side effect can be weight gain, independent of the other causes of weight gain when you’re depressed. Although I’ve even seen some patients lose weight on antidepressants in my own practice, by far, more patients put on weight, and research indicates that being on an antidepressant puts you at an increased risk of weight gain⁵. Even people of normal weight are at risk of becoming overweight or obese. When you’re on an antidepressant, you’re more likely to gain weight in year 2 or 3 of treatment. And the risks of weight gain increase at least into the sixth year of use.

While the rates of weight gain vary, and are due to multiple factors such as depression and lack of exercise, the sertraline itself can make you gain 10 pounds in a year⁶, more than twice the weight gain if you are on fluoxetine (Prozac).

The perplexing and different consequence of being on sertraline is that, at least in animal studies⁷, it is associated with an increase in blockage of your heart’s arteries⁸. However, it does this without increasing lipid concentrations, either total lipids, high-density lipoprotein, or the ratio between the two. In fact, this risk is close to 5X higher than if animals (monkeys) were not treated.

Also, the results of this study in animals is somewhat perplexing since in this study, it wasn’t even that sertraline caused weight gain (depressed monkeys often have weight loss). The one key metabolic finding was a decrease in adiponectin, which correlated with the arterial blockage. This makes sense because adiponectin usually protects the heart in various ways by dilating blood vessels, preventing tissue destruction by toxic radicals, decreasing inflammation, and preventing cell death⁹,¹⁰.

Given that heart disease is a leading cause of death globally¹¹, it would benefit patients if prescribers emphasized this risk, and also simultaneously prescribed a very different diet. For sertraline (Zoloft) specifically, there are some easy ways you can start to do this:

1. Stop the Western diet habits immediately, but do this reasonably, or you will rebound. There’s no point in feeling less depressed if you’re increasing your chances of heart disease at the same time. And when you’re on a Western diet, drugs like sertraline are more likely to cause weight gain than when you’re not¹². In fact, the higher your antidepressant dose, the higher your weight gain, but only if you are on a Western diet.

The Western diet is typically characterized by a high content of proteins (derived from fatty domesticated and processed meats), saturated fats, refined grains, sugar, alcohol, salt, and corn-derived fructose syrup, with an associated reduced consumption of fruits and vegetables.

It’s not helpful to simply present this list to patients, as this often sounds like you are telling them to stop eating everything they like. If they’re depressed, they will not be inclined to do this.

I suggest starting with eliminating foods with high-fructose corn syrup: soda, candy, sweetened yogurt, and many salad dressings. Even some low-fat yogurts have too much sugar¹³ and just one tablespoon of fat-free French dressing has 3 g of sugar¹⁴. If you have 3 tablespoons of dressing, you’ve already had a quarter of your daily sugar allowance if you’re a man, and more than 1/3 of your daily allowance if you’re a woman¹⁵. Even granola bars¹⁶ have too much sugar. And you’d be advised to avoid breakfast cereals like Frosted Flakes, Cocoa Puffs, and Fiber One¹⁷.

2. Increase foods that increase adiponectin: A typical Mediterranean diet is associated with higher levels of adiponectin¹⁸. Also, foods with a low glycemic index (GI) and high fiber can increase adiponectin.

This can all be mind-boggling to someone who is depressed. The three basic recommendations here are¹⁸: Eat foods with omega-3-fatty acids like avocado, nuts, fatty fish and olive oil. This could increase your adiponectin by 14-60%. Diets rich in fiber will increase adiponectin by 115%¹⁹. Chia or basil seeds are an amazing source of fiber (they can add this to your gut health, but skip fruited yogurt.). The fiber in chia seeds exceeds dried fruit, cereal, or nuts²⁰. And low glycemic foods include steel-cut oats and butter beans. Use zucchini noodles (zoodles) as a way to get your pasta kick as this is low-calorie, filling, and adds fiber to your meals too.

If you’re wondering how to remember all of this, I have a mnemonic that I use called the “ZOLOFT” diet:

Z = Zest of lemon (instead of salad dressing)
O = Olive oil
L = Legumes (e. g. lentils and chickpeas)
O = Oats, steel-cut
F = Fiber
T = Turkey (or another lean protein, like seafood)

Of course, this doesn’t cover everything but it’s a useful guide and easy to remember if you want to control your weight while on sertraline.

Does Sertraline Affect Weight Gain Or Loss?

Zoloft is an antidepressant drug prescribed for people clinically diagnosed with depression, anxiety, and other mental health disorders. It can help them better manage their condition since SSRIs (selective serotonin reuptake inhibitors), antidepressants like this drug, work by boosting a patient’s mood while simultaneously relieving depressive symptoms.

However, use of this medication is associated with risks that include drug abuse and addiction, and, among others, Zoloft weight gain or loss. While the changes in mass during treatment may seem like a shallow concern, it can just as easily cause or aggravate a mental condition and its symptoms. Learn the medical reasons why weight changes happen during and after taking sertraline and how this can be prevented.

Zoloft Side Effects on the Body Mass

There is a complex relationship between depression, Zoloft medication, and changes in patients’ weight. With 12.7% of Americans 12 years and over reporting taking antidepressants, it is imperative that increased mass and obesity resulting from taking antidepressants be prevented. Zoloft weight gain and loss can happen during the treatment process on these SSRI medications.

No less than the Centers for Disease Control and Prevention reported that, based on data collated between 2005 and 2010, 43% of adults in the US who were clinically diagnosed with depression were obese. Another key finding was that as much as 55% of adults who took antidepressants were obese.

The possible cyclical association of depression-obesity-and further depression was highlighted by a study that demonstrated how individuals who have been diagnosed with severe obesity were much more likely to be depressed.

The association of Zoloft and weight gain can breed patient dissatisfaction and increase the likelihood of non-compliance to treatment schedules. These findings stress the importance of weight management, including healthy eating, when taking antidepressant drugs.

Does Zoloft Cause Weight Gain?

Whether or not Zoloft antidepressant leads to sertraline weight gain remains to be highly debatable. Contradicting studies have surfaced. Some experts believe that these drugs lead to an increase in body mass. However, other studies have shown either a null or negative relationship between obesity and the use of a psychotropic drug for the treatment of depression.

The following explanations have been brought up among those who think that sertraline and extra pounds are positively correlated. Some of which derived from specific studies involving sertraline, while others were deduced from associations made between obesity and other antidepressants.

A Few Extra Pounds is a Sign of Recovery from Depression

Experts argue that observed body mass changes in patients taking sertraline for a clinically diagnosed mental disorder could, in fact, be a sign of recovery rather than a pharmacological side effect.

This conclusion was reached following the observation of 100 patients, 72% of whom were observed to have gained some pounds after rebounding from a depressive state.

This was a conclusion that was supported by another group of researchers who found patients recovering from depression soon gained some pounds while momentarily experiencing the loss at the start of treatment with Duloxetine. It belongs to a class of antidepressants known as serotonin-noradrenaline reuptake inhibitors.

Sertraline Affects Normal Thyroid Function

In a study by Carvalho, Bahls, and Boeving, the effects of fluoxetine and sertraline on patients divided into two groups were observed. Each patient who has either been diagnosed with hypothyroidism showed normal thyroid function at the start of treatment. Higher body mass, due to the reduction of the hormone, T3 was specifically observed among those starting treatments without any thyroid-related disorder. T3 helps regulate metabolism. With less of it in the body, therefore, metabolism and energy expenditure go down as body mass increases.

Other Factors Affecting Weight Gain

Several factors can trigger sertraline weight changes among patients medicating on Zoloft. Some of which are listed below.

Eating Habits and Lifestyle

Individual factors like genetic interactions to sertraline, including:

metabolism
lifestyle
hormones
stress level
exercise
dietary intake
pregnancy or breastfeeding

Other conditions also may influence an increase in body mass. In particular, a study found associations between increased mass, treatment with SSRI medications, the Western diet, lack of physical activity, and smoking.

Depressive Symptoms Involving Appetite and Nutrition

It must be noted that depressive symptoms may include either a significant loss of appetite or a significant increase in people’s eating habits. Either way, the affected person already makes poor food choices even before obtaining treatment for a mental disorder or, more specifically, started the use of Zoloft.

Another study noted that women prescribed to take antidepressants were more likely to be obese. The researchers also positively associated increased body mass while on treatment with a prior history of anxiety and depression.

Dosage and Period of Medication

It is now well-recognized that prolonged use of antidepressants can cause mass changes. One study that demonstrated this was published in the British Medical Journal in 2018. The researchers noted that patients who took an antidepressant medication longer also experienced a more dramatic change in body mass.

Dosage is perhaps the most important factor in the equation. A higher dosage means that people give the medication more control over their nervous system than the innate homeostatic functioning. In this case, if an individual experiences an increase in the mass at a lower dose, the increased dosage can double the body size and lead to sertraline HCL high.

The duration of sertraline intake also plays a vital role in determining how many pounds one has gained. Prolonged usage of the drug makes individuals tolerant to its effects and leads to the dosage increase.

Reaction with Other Drugs

If patients are taking other medications or mixing sertraline with cannabis, or drinking during the Zoloft treatment course, then they can’t rule out the fact that the interaction effect could increase the body mass.

Preventing Sertraline Weight Gain

Health professionals are advising the next steps to avoid sertraline weight gain:

Before starting on Zoloft, get weighed and report about all the changes to the doctor. The first step to prevent an increase in patients’ mass is by monitoring the scale and waist circumference regularly.
Improve nutrition and be selective about food choices. Try incorporating high-adiponectin food sources to a regular diet, such as avocados and chia seeds, which is high in fiber.
Perform exercises and engage in physical activities regularly. Not only will this help keep off the extra pounds but also improve mood.

Sertraline Weight Loss

While it is more likely for a person to get some extra pounds when taking sertraline, fat loss may also happen. If a person is burning a lot of extra calories or is following a reduced-calorie diet while being on Zoloft, fat loss can occur.

Loss of appetite and nausea are also two possible sertraline side effects that could lead to a mass loss. Again, loss of appetite and Zoloft weight loss could already be a symptom of depression, as stressed above. These symptoms may be aggravated by sertraline use.

The study published in Psychoneuroendocrinology journal in 2016 stated that monkeys put on Sertraline HCL were found to avoid an increase in body fat and insulin levels as compared to the monkeys who had just regular meals.

To stay healthy and prevent Zoloft weight loss, the three recommendations in the previous section should also be observed.

Managing Weight After Discontinuing Zoloft

People are often surprised when they find out that they have gained 10 to 15 pounds while being on their medication post discontinuation. It can happen because drugs like Zoloft directly interact with the body functions at the core level. Metabolism, therefore, is certainly impacted by making consequent changes in body mass, just an accompanying effect from Zoloft discontinuation.

Health professionals suggest the water retention may also be the underlying cause of sudden mass gain during or after medicating with Zoloft. However, once sertraline is removed from the system, excess water would also be lost. Unfortunately, this process could take weeks.

However, there are always methods provided by health professionals to minimize the extra pounds gained. Make sure to consult with a qualified medical health professional to discuss the most appropriate weight management options that match individual profiles and lifestyles.

Consider signing up for community-based weight management programs specially designed for patients taking meds to treat various mental health disorders. Patients can minimize their body mass changes risk by receiving an individually planned diet plan and exercise regime. Aerobic exercises are the best-suitable technique that can help to lose weight being on the Zoloft post discontinuation period.

Page Sources

Gafoor R, Booth H, and Gulliford M, Antidepressant utilisation and incidence of weight gain during 10 years’ follow-up: population based cohort study, 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964332/
Pratt, L. Centers for Disease Control and Prevention. Depression and Obesity in the US Adult Household Population, 2005-2010, https://www.cdc.gov/nchs/products/databriefs/db167.htm
Onyike, C, Crum R, Lee H, Is obesity associated with major depression? Results from the Third National Health and Nutrition Examination Survey, 2003, https://pubmed.ncbi.nlm.nih.gov/14652298/
Benazzi F. Weight gain in depression remitted with antidepressants: pharmacological or recovery effect?, 1998, https://pubmed.ncbi.nlm.nih.gov/9693356/
Wise T, Perahina, D, Effects of the antidepressant Duloxetine on Body Weight: Analyses of 10 Clinical Studies, 2006, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1764530/
Carvalho G, Bahls, S, Effects of selective serotonin uptake inhibitors on thyroid function in depressed patients with hypothyroidism or normal thyroid function, 2009, https://pubmed.ncbi.nlm.nih.gov/19583486/
Shi Z, Atlantis E, Taylor AW, SSRI antidepressant use potentiates weight gain in the context of unhealthy lifestyles: results from a 4-year Australian follow-up study, 2017, https://bmjopen.bmj.com/content/7/8/e016224.citation-tools
Rao TS, Understanding nutrition, depression and mental illnesses, 2008, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738337/
Grundy A, Cotterchio M, Associations between anxiety, depression, antidepressant medication, obesity and weight gain among Canadian women, 2014, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0099780
Wharton S, Effectiveness of a community-based weight management program for patients taking antidepressants and/or antipsychotics, 2019, https://onlinelibrary.wiley.com/doi/full/10.1002/oby.22567
Zoloft Tablets and Oral Concentrate. Label. https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/019839s070,020990s032lbl.pdf

Published on: October 4th, 2018

Updated on: December 18th, 2020

Nena Messina is a specialist in drug-related domestic violence. She devoted her life to the study of the connection between crime, mental health, and substance abuse. Apart from her work as management at addiction center, Nena regularly takes part in the educational program as a lecturer.

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care. He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.

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A Diet to Manage Sertraline (Zoloft)-Induced Weight Gain

If you’re wondering how to remember all of this, I have a mnemonic that I use called the “ZOLOFT” diet:

Z = Zest of lemon (instead of salad dressing)
O = Olive oil
L = Legumes (e.g. lentils and chickpeas)
O = Oats, steel-cut
F = Fiber
T = Turkey (or another lean protein, like seafood)

Of course, this doesn’t cover everything but it’s a useful guide and easy to remember if you want to control your weight while on sertraline.

90,000 Antidepressant Pfizer Zoloft – “My bitter experience, side effects and advice for girls”

I understand that after this review, everyone who can unsubscribe from me, the rest will simply stop reading. But I believe that I should write this review for those who may be taking this drug. Perhaps, after reading, someone will change his mind, and someone will draw conclusions.

Today I will tell you about how I took the Antidepressant Zoloft Zoloft.

Antidepressant Zoloft

I will not go into details – I will say this – it was VERY bad for me.How to live and be further I did not know, I went to work by inertia, and I was already thinking of quitting this very work and sitting whining in a corner. I have never been able to cry for days on end, but pouring alcohol into grief … well, I don’t drink alcohol – I don’t like it.

And over time it got worse and worse.

Antidepressant Zoloft

The only effort that I managed to make was to scrape myself together with the last bit of strength and go to the doctor.And tell the doctor everything. The doctor, of course, could advise me a good psychoanalyst who would put everything in my head on the shelves, but he decided that I had enough medicines. And he appointed me Zoloft.

It was only later that I found out that this Zoloft is quite a terrible thing. But then I had at least some hope that I would get better, and colors would appear in my world.

PRICE OF GOLD

I must say right away that it is not cheap (Pfizer is not a Borschagovsky plant for you), but is sold only by prescription.In 2010-2011, such a package cost 150 hryvnias … In 2018, such a package costs already 400 – 500 hryvnias … so it’s not that hard to cut it). After a while, in half. And then you can already kiss. I took it all once a day, in the morning before work.

The duration of the use of the antidepressant will have to be prescribed by your doctor, and he will also need to be monitored all this time.

NUANCE

You also need to get off Zoloft gradually – that is, if you take a whole pill, then half, and then a quarter. And then – you need to take it for a week or two, it does not happen in a day. Such measures are needed so that the withdrawal syndrome does not hit you on the head (this is when everything you fought with comes back, sometimes in doubled quantity. Class, right? I say – a terrible thing).

COURSE

The course of admission was personally assigned to me at first 3 months.The subsequent one was 6 months.

ACTION .

Zoloft’s active ingredient is sertraline .

Watching

Sertraline is the active ingredient in Zoloft. It stops the re-uptake (reuptake) of serotonin, which is made by the neurons that secrete it. As a result, the concentration of the neurotransmitter increases in the synaptic cleft and the main cause of depression, serotonin deficiency, is eliminated.The effect on serotonin receptors is responsible for a significant correction of the mental state of patients with depression. It manifests itself in an increase in mood, elimination of phobias, anxiety states, a decrease in feelings of melancholy, a decrease in appetite

And serotonin is, if anything, what is called the hormone of happiness. And if you have enough of this hormone, you can survive everything. Not because you are strong and understand with your head that this must be experienced, but you simply do not pay attention to any grief or trouble.

I will not lie – when I took Zoloft, I was … beautiful, fearless, joyful. It was not that there was any grief on my shoulder – I became an ideal version of myself. Griefs were easily tolerated and forgotten, and joys sparkled so that it seemed the whole world was happy with me. I even went to courses that I was afraid to go to because of someone else’s opinion, I talked with people with whom I would not have spoken before and there was a lot of things. I could just walk down the street with a player in my ears and feel that here it is, life and nothing else is needed

This is how serotonin works.

But you understand that this is a beautiful wrapper, a shiny side of the coin, and there is something else …

SIDE EFFECTS.

I have already spoken about the withdrawal syndrome. I was not lucky enough to run into him, but I was afraid of him.

Here the instruction suggests that

The use of Zoloft tablets may be accompanied by: – diarrhea; – pancreatitis; – dizziness; – tremor of the extremities; – nausea; – vomiting; – epigastric pain; – constipation; – dry mouth; – change appetite; – hyponatremia; – coma; – headache; – feeling of euphoria; – loss of consciousness; – migraine; – paresthesia; – convulsions; – hypoesthesia; – drowsiness; – hyperkinesia; – agitation; – hyperhidrosis; – fever; – gait disturbance ; – tachycardia; – insomnia; – nightmares; – cramps of the jaw muscles; – involuntary muscle contractures; – mental disorders; – hallucinations; – decreased libido; – galactorrhea; – delayed ejaculation; – gynecomastia; – priapism; – alopecia; ; – facial edema; – angioedema; – photosensitivity; – periorbital edema; – skin rash; – hypertension; – epidermal necrolysis; – Stevens-Johnson syndrome; – leukopenia; – thrombocytopenia; – tachycardia; – palpitation; – bleeding from the nose, gastrointestinal tract; – hematuria; – hot flashes; – hyperprolactemia; – hypoaldosteronism syndrome; – hypothyroidism; – mydriasis; – visual impairment; – hepatitis; – manic moods; – liver failure; – increased levels of ALT, ASAT – an increase in the concentration of cholesterol; – arthralgia; – enuresis; – bronchospasm

But personally in my case… I was losing weight. Just hellish and brutal. From 55 kg with a height of 163 cm, I began to weigh 42 kg. At the same time, I ate what I wanted, but the weight went away and I could not do anything. It scared me. But my reflection in the mirror scared me more than that – I will not show the photos for the reason that I did not have them left. At work, they thought that I was terminally ill with something (rumors reached me). I liked my 55 kg. I look pretty even with 50 kg, but 42 made me a walking corpse. Who looks happy and smiles, but nonetheless.I DON’T LIKE it, it scared me. I complained to the doctor – he said to endure. I suffered. Then I finished the course of the drug … AND THE WEIGHT RETURNED. Moreover, with a surplus. I began to weigh over 60 kg. I went on diets, went to dances – but nothing helped me. The weight held on. IT IS VISIBLE TO DISRUPT THE EXCHANGE OF SUBSTANCES. I walked like this for about a year … then the weight began to slowly, completely imperceptibly go away … And then I returned to normal. It is clear that such overloads are not at all a joy for the body. I still remember with a shudder what I looked like.

And one more side effect – ZOLOFT hits the kidneys very much. After the end of the admission, it was just summer, my legs were swollen. Ankles. It was impossible to hide it (in the summer!) – so …. it was terrible. All these diuretics and others just didn’t help me.

In general, after that I decided that no matter how difficult it was for me, the shrink is my everything. In extreme cases, I will try to get out myself. No more antidepressants. Yes, you can live with them, but … for me, the side effects are not worth it.Weight, swelling – this is not at all what I am ready to pay off.

I know that many girls go to tricks to get them Zoloft, because they dream of sitting on their butts straight and being thin – GIRLS, you don’t need to do this, there are many other ways, but this one is tough for health, and yours the weight will still return to you, do not do it!

I give 4 points because Zoloft really works, helps.

I recommend Zoloft, because there are cases in life when you can’t get out without medication.But to accept or not is up to you.

Be Healthy ♥

Sertraline: Pediatric Medication | Memorial Sloan Kettering Cancer Center

This document, provided by Lexicomp ^®, contains all the information you need to know about the drug, including the indications, route of administration, side effects and when you should contact your healthcare provider.

Trade names: USA

Zoloft

Trade names: Canada

ACT Sertraline [DSC]; AG-Sertraline; APO-Sertraline; Auro-Sertraline; BIO-Sertraline; DOM-Sertraline; JAMP-Sertraline; Mar-Sertraline; MINT-Sertraline; MYLAN-Sertraline [DSC]; NRA-Sertraline; PMS-Sertraline; Priva-Sertraline; RAN-Sertraline; RIVA-Sertraline; SANDOZ Sertraline [DSC]; TEVA-Sertraline; VAN-Sertraline [DSC]; Zoloft

Warning

Drugs like this have increased the likelihood of suicidal thoughts or actions in children and young people.This risk may be higher in people who have attempted suicide or have had suicidal thoughts in the past. All people taking this drug must be closely monitored. Call your doctor right away if you have signs such as depressed mood (depression), nervousness, anxiety, grumpiness, or anxiety attacks, or if other mood or behavior changes occur or worsen. Call your doctor immediately if you have suicidal thoughts or attempted suicides.

What is this drug used for?

The drug is used to treat depression.
Used to treat obsessive-compulsive disorder.
Used to treat panic attacks.
Used to treat Post Traumatic Stress Disorder (PTSD).
It is used to treat emotional lability in women in the premenstrual period.
This medication is used to treat social anxiety disorder.
This drug can be given to children for other indications. Consult your doctor.

What do I need to tell my doctor BEFORE my child takes this drug?

All forms of issue:

If your child is allergic to this drug, any of its ingredients, other drugs, foods, or substances. Tell your doctor about the allergy and how your child has it.
If your child has liver disease.
If a child is receiving any of the following: linezolid or methylene blue.
If your child is taking pimozide.
If your child has taken drugs for depression or some other medical condition in the past 14 days. These include isocarboxazid, phenelzine, and tranylcypromine. An episode of very high blood pressure may occur.
If your child is taking any drugs that can cause some type of abnormal heart rhythm (prolonged QT interval).There are many drugs that can have this effect. If in doubt, consult your doctor or pharmacist.
If your daughter is pregnant or is likely to become pregnant. Some forms of this drug are not intended for use during pregnancy.

Liquid:

If your child is allergic to latex. The pipette has an elastic band.
If your child is taking disulfiram.

This list of drugs and diseases that may be adversely associated with this drug is not exhaustive.

Talk to your doctor or pharmacist about all medications your child is taking (prescription and over-the-counter, natural products, and vitamins) and any health concerns. You need to make sure that this drug is safe for your child’s illness and in combination with other drugs he is already taking. You should not start, stop, or change the dosage of any drug your child is taking without talking to your doctor.

What do I need to know or do while my child is taking this drug?

Tell all providers who care for your child that your child is taking this drug. These are your child’s doctors, nurses, pharmacists and dentists.
Have your child avoid tasks or activities that require attention until you see how this drug is working for your child.This includes cycling, playing sports, or using items such as scissors, lawn mowers, electric scooters, toy cars, or motorized vehicles.
Do not suddenly stop giving this drug to your child without talking to your doctor. This can increase your child’s risk of side effects. If your child needs this drug, stop taking this drug gradually, as directed by the doctor.
Alcohol may interact with this drug. Make sure your child does not drink alcohol.
Consult with your child’s doctor before using marijuana, other forms of cannabis, prescription or over-the-counter drugs that may slow down your child’s actions.
If you are depressed after starting this drug, sleep and appetite may improve quickly. Other symptoms of depressed mood may take up to 4 weeks to improve.
This drug may increase the chance of bone fractures. Consult your doctor.
This drug may increase the risk of bleeding. Sometimes bleeding can be life-threatening. Consult your doctor.
This drug may lower sodium levels. Very low sodium levels can be life-threatening, leading to seizures, fainting, difficulty breathing, or death.
This drug may interfere with some lab tests.Tell all healthcare professionals and laboratory staff providing your child’s healthcare that your child is taking this drug.
This drug is not approved for use in children of all ages. Check with your doctor to make sure this drug is right for your child.
Use with caution in children. Consult your doctor.
In some cases, the drug may affect the growth rate in children and adolescents.They may need to check their growth rate regularly. Consult your doctor.

If your daughter is pregnant:

Taking this drug late in pregnancy may increase the risk of breathing or eating problems, low body temperature, or withdrawal symptoms in the newborn. Please consult your doctor.

If your daughter is breastfeeding:

Tell the doctor if your daughter is breastfeeding.You will need to be consulted about the possible risks to the child.

What side effects should I report to my child’s healthcare provider right away?

WARNING / CAUTION: Although rare, this drug can cause very serious and sometimes deadly side effects in some people. Call your child’s doctor right away or get medical attention if your child has any of the following signs or symptoms that could be associated with a very bad side effect:

Signs of an allergic reaction such as rash, hives, itching, reddened and swollen skin with blistering or scaling, possibly associated with fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue, or throat.
Signs of low sodium levels such as headache, trouble concentrating, memory impairment, confusion, weakness, seizures, balance problems.
Signs of bleeding such as vomiting or coughing up blood; vomiting of the type of coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; non-cyclic vaginal bleeding; bruising that occurs or increases for no reason; bleeding that you cannot stop.
Symptoms of a severe skin reaction (Stevens-Johnson syndrome / toxic epidermal necrolysis) such as redness, swelling, blistering or scaling of the skin (with or without fever), redness or irritation of the eyes, ulcers in the mouth, pharynx, nose or eyes.
Convulsions.
Inability to control the bladder.
Significant weight gain or loss.
A serious and sometimes fatal complication called serotonin syndrome may occur.This risk may be increased if the child is also taking certain other drugs. Call your child’s healthcare provider right away if your child is agitated, imbalanced, confused, hallucinations, fever, tachycardia or irregular heartbeat, flushing, muscle twitching or stiffness, seizures, tremors or tremors, excessive sweating, severe diarrhea, nausea or vomiting, very bad headache.
There may be an increased risk of eye problems with this drug.Your child’s doctor may order your child to see an ophthalmologist to see if they are at increased risk of developing these eye problems. Call your doctor right away if your child develops eye pain, change in vision, swelling, or redness around the eye.
Some type of heart rhythm disorder (long QT interval) has happened with this drug. Sometimes it caused another type of heart rhythm disturbance (polymorphic ventricular tachycardia of the “pirouette” type).Call your doctor right away if your child has tachycardia, irregular heartbeats, or fainting.
Liver problems have rarely happened with this drug. Sometimes these cases were fatal. Call your child’s doctor right away if your child develops signs of liver problems such as dark urine, tiredness, lack of appetite, nausea or abdominal pain, discolored stools, vomiting, yellowing of the skin or eyes.

If your child is or may be sexually active:

Sexual problems such as decreased sex drive or ejaculation problems.

What are some other side effects of this drug?

Any drug can have side effects. However, many people have little or no side effects. Call your child’s doctor or get medical help if any of these or other side effects bothers your child or does not go away:

Feeling dizzy, sleepy, tired, or weak.
Constipation, diarrhea, abdominal pain, nausea, vomiting, or decreased appetite.
Dry mouth.
Sleep disorders.
Excessive sweating.
Shiver.

This list of potential side effects is not comprehensive. If you have any questions about side effects, talk to your child’s doctor. Talk to your child’s doctor about side effects.

You can report side effects to the National Health Office.

What is the best way to give this drug?

Give this drug to your child as directed by the doctor. Read all the information provided to you. Follow all instructions strictly.

Pills:

Give this drug with or without food.
Continue giving this drug as directed by your child’s doctor or other healthcare professional, even if your child is well.

Capsules:

Give this drug with food.
Continue giving this drug as directed by your child’s doctor or other healthcare professional, even if your child is well.

Liquid:

Only use the measuring container supplied with the liquid preparation.
Mix liquid with 120 ml water, ginger ale, lemon soda, lemonade, or orange juice.
Give the dose immediately after mixing. Do not store for future use.
This drug may look cloudy after mixing. This is fine.
Continue giving this drug as directed by your child’s doctor or other healthcare professional, even if your child is well.

What if my child misses a dose of a drug?

Give the missed dose as soon as possible.
If it is time for your child to take the next dose, do not take the missed dose and then return to your child’s normal dosage schedule.
Do not give a double dose at the same time or additional doses.

How do I store and / or discard this drug?

Store at room temperature.
The cover must be tightly closed.
Store in a dry place. Do not store in the bathroom.
Store all medicines in a safe place.Keep all medicines out of the reach of children and pets.
Dispose of unused or expired drugs. Do not empty into toilet or drain unless directed to do so. If you have any questions about the disposal of your medicinal products, consult your pharmacist. Your area may have drug recycling programs.

General information on medicines

If your child’s symptoms or health problems do not improve, or if they get worse, see your child’s doctor.
Do not share your child’s medication with others or give anyone else’s medication to your child.
Some medicines may come with other patient information sheets. If you have questions about this drug, talk with your child’s doctor, nurse, pharmacist, or other healthcare professional.
A separate patient instruction sheet is attached to the product. Please read this information carefully.Reread it every time you replenish your supply. If you have questions about this drug, talk with your doctor, pharmacist, or other healthcare professional.
If you think an overdose has occurred, call a Poison Control Center immediately or seek medical attention. Be prepared to tell or show which drug you took, how much and when it happened.

Use of information by the consumer and limitation of liability

This information should not be used to make decisions about taking this or any other drug.Only the attending physician has the necessary knowledge and experience to make decisions about which drugs are suitable for a particular patient. This information does not guarantee that the drug is safe, effective, or approved for the treatment of any disease or specific patient. Here are only brief general information about this drug. It does NOT contain all available information on the possible use of the drug with instructions for use, warnings, precautions, information about interactions, side effects and risks that may be associated with this drug.This information should not be construed as a treatment guide and does not replace information provided to you by your healthcare professional. Check with your doctor for complete information on the possible risks and benefits of taking this drug. Use of this information is governed by the Lexicomp End User License Agreement available at https://www.wolterskluwer.com/en/solutions/lexicomp/about/eula.

Copyright

90,000 8 Popular Myths About Antidepressants

Daniil Davydov

medical journalist

Author’s profile

In 2017, 3.4% of the world’s population suffered from depression – that is, 264 million people.

At the same time, the drugs for this disease are surrounded by many myths. Antidepressants are blamed for ineffectiveness and severe side effects, but often the problem is not with the drugs themselves, but rather that they are misused.

We have collected 8 myths about antidepressants and found out how close they are to the truth.

See your doctor

Our articles are written with a passion for evidence-based medicine. We refer to reputable sources and go for comments from reputable doctors. But remember: the responsibility for your health lies with you and your doctor. We do not write prescriptions, we make recommendations. It is up to you to rely on our point of view or not.

Myth 1

Antidepressants almost never help

Most likely, this myth arose due to the fact that antidepressants do not work in all patients – so even some doctors and scientists doubt their effectiveness.However, it is impossible to call antidepressants ineffective, just there are important nuances in the use of these drugs.

These medicines help people whose problems are associated with a deficiency or excess of neurotransmitters. Antidepressants reduce symptoms of depression, obsessive-compulsive disorder, generalized anxiety disorder, post-traumatic stress disorder, and bipolar disorder.

There is evidence of the effectiveness of antidepressants in chronic pain.Antidepressants increase the amount of neurotransmitters in the spinal cord – this reduces pain signals.

Most experts have no doubts that antidepressants work. For example, the British Royal College of Psychiatry estimates that 50-65% of people with depression who take antidepressants do better, compared with 25-30% of those who take placebo.

However, there are situations where the benefits of antidepressants are questionable. For example, antidepressants are useful for treating moderate to severe depression, but they do not work well for people with mild depression – psychotherapy is more suitable for them.

And there are also situations when these drugs were prescribed by mistake. Then antidepressants won’t really help.

When antidepressants do not help

Sergey Divisenko

psychotherapist

There are three cases when problems with antidepressants most often arise.

The antidepressant did not help because the doctor prescribed the wrong dose. The minimum doses of these drugs do not help in half of the cases.Then the competent doctors increase the doses to those recommended in the clinical guidelines, and the illiterate refuse them.

Sometimes, for antidepressants to work, they need to be augmented – that is, enhanced – with other classes of drugs. For example, second-generation antipsychotics, or normotimics, that is, drugs that stabilize mood. If this is not done, the person taking antidepressants will not feel relieved.

The antidepressant did not help because the doctor misdiagnosed and tried to treat a disease in which these drugs do not work.To help the person, it was necessary either to use other drugs or to apply non-drug treatments such as psychotherapy, transcranial stimulation, or electroconvulsive therapy.

For example, in bipolar disorder, symptoms can be very similar to depression or anxiety disorder. But for bipolar disorder, antidepressants work only if they are used in conjunction with other medications called normotimics. By themselves, they will either work for a short time, or they will not work, or they can cause a phase inversion – that is, a person will switch from a depressive phase to a manic one.

The patient was not helped by a particular antidepressant, but another could. Antidepressants differ according to the principle of action – on this basis, they are divided into classes. It happens that one antidepressant does not work, but another from the same or different class helps. If the treatment does not work, you need not stop drug therapy, but continue to look for a drug that will help this particular patient.

Myth 2

Antidepressants only relieve symptoms, but do not address the cause of the disorder.

In most cases, this is not a myth.However, in some situations, antidepressants target the underlying cause of the disorder.

Depression is a heterogeneous disease. Experts distinguish a different number of depression subtypes – from 4 to 12. But for our purposes, depression can be roughly divided into two large subtypes.

American Criteria for Depressive Disorders – DSM-5PDF Psychiatrist’s Guide, 32 MB

What Depression Is – International Physician’s Manual UpToDate

Depression provoked by external causes: psychological trauma, internal conflicts, wrong way of thinking or illness not related to depression.Disorders that can be attributed to this group are more common.

If these reasons affect a person long enough and he does not understand how to cope with them, depression may develop. In this situation, antidepressants act as medications that relieve the symptoms of the disease. Psychotherapy is needed to address the cause of the problem.

Depression provoked by internal causes. Approximately 7% of people with depression have a correct way of thinking, no internal conflicts and trauma, and no serious illnesses.In this situation, the cause of depression is a lack of neurotransmitters: serotonin, norepinephrine and dopamine in the synapses of the nerve cells of the brain. In such people, the antidepressant acts precisely on the cause of the disease, that is, it corrects the production of serotonin in the synapses of neurons.

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Myth 3

As soon as you get better, you can stop using the antidepressant.

This is also not quite a myth – it would be more correct to call it a belief, which is true only for some, but not all patients with depression.

As a rule, it is advised to continue taking antidepressants for at least six months after remission has occurred. If the duration of the disease is short, that is, the person was sick for about two weeks, then for the onset of remission, it is usually necessary to take medications for one to two months. If the duration of the disease is long, from several months or years, then more time is required for the onset of remission. To say exactly how much will not work: different people with depression have different recovery times.

Some people have recurrent, that is, repetitive depression. In this case, the period during which you need to take the medicine depends on how many bouts of depression have already occurred during your life. If more than three – antidepressants are recommended to be taken for several years or for life.

Myth 4

Antidepressants are addictive

This myth may be rooted in the fact that some people need to take medications for depression for life.And at the beginning of treatment, some patients have to increase the dose. But in fact, antidepressants do not cause either true physical or drug addiction.

True physical dependence on a drug is a situation when a person gets so used to the drug that when it is canceled, the symptoms of the disease increase sharply. People who are dependent on the drug have to increase the dosage, otherwise the drug stops helping.

What True Drug Addiction Is – National Institute for the Study of Drug Abuse Bulletin PDF, 7 MB

What Is Drug Addiction – American Psychiatric Association Bulletin

Drug addiction may include physical addiction to drugs.But this addiction has a unique trait. Addiction can also develop in a healthy person who used the drug not to recover, but to get pleasure. But when he tries to give up the drug, he still has physical distress called withdrawal. As a result, a person is forced to look for a new dose of a narcotic substance.

Although a person who takes antidepressants to treat depression gets better, the drugs themselves are neither enjoyable nor addictive.Taking them as drugs is useless.

Of all the drugs that are used in psychiatry, only psychostimulants and anti-anxiety drugs that activate mental activity, that is, benzodiazepine tranquilizers, can cause true physical dependence. Antidepressants are not included in this list, because there is no need to increase the dosage of correctly selected drugs from this group.

At the same time, some people who early stop taking antidepressants sometimes experience withdrawal symptoms – nausea, trembling hands, and some feel “shocks” in the head, similar to sensations from an electric shock.Patients who need to take the medicine for a very long time return symptoms of depression.

Antidepressants are sometimes abused, but they cannot cause addiction – Journal of Modern Psychiatry

To avoid unpleasant consequences, you can stop taking antidepressants only if your doctor says that they are no longer needed. But even in this situation, antidepressants should be withdrawn slowly, that is, gradually reducing the dose. This will help avoid unpleasant side effects.

Myth 5

A person on antidepressants becomes lethargic and loses interest in life.

This popular myth is based on real but outdated data.

Such changes in the psyche are observed in patients taking tricyclic antidepressants of the first generation, such as amitriptyline. It has a sedative, that is, sedative, effect. A person who takes high dosages of amitriptyline can actually become sleepy and indifferent to the world around them.

Amitriptyline – sedative – International drug database Drugs.com

SSRIs do not sedate – International drug database Drugs.com

Modern second-generation antidepressants with which treatment is recommended, such as selective serotonin reuptake inhibitors, or SSRIs, almost never cause drowsiness and apathy.

On the contrary, in most people with depression, they return interest in life.

Sometimes SSRIs still cause drowsiness, but so far it has not been proven

Sergey Divisenko

Psychotherapist

It is believed that in rare cases modern antidepressants can provoke SSRI-induced apathy. But this condition is extremely rare.

And then psychiatrists still doubt that the reason is precisely in the drugs, and not in the patient’s condition. Indeed, some people while taking antidepressants may develop other unfavorable mental conditions in which apathy occurs: for example, schizotypal disorder that has not been noticed before.

Myth 6

Antidepressants have many side effects

This is partly true: both SSRIs and antidepressants from other groups have side effects. But it is quite possible to cope with them.

At the beginning of treatment, when people are just starting to take antidepressants, many complain of increased anxiety, dry mouth, nausea, and trouble sleeping. But after a few days or weeks after starting treatment, these symptoms usually go away. If the side effects persist, it makes sense to see a doctor – he will replace the antidepressant.

How to Cope with the Side Effects of Antidepressants – Tips from the Mayo Clinic

Here’s what to do before the side effects go away:

take antidepressants with meals, unless the instructions say otherwise, so the antidepressant will less irritate the stomach;
put a bottle of clean water on the work table – if you have dry mouth, you can take a sip. Even for dry mouth, unsweetened candies and chewing gum help;
Walking for at least half an hour before going to bed will make it easier to fall asleep.If you can’t sleep at all, you can ask your doctor to pick up sleeping pills.

The second most common side effect is increased anxiety at the start of antidepressant use. To avoid this problem, psychiatrists use two effective methods:

titrate the dose – that is, start with the minimum dose of antidepressant, and then gradually increase it;
at the beginning of admission, together with an antidepressant, sedatives are prescribed – tranquilizers.

A third common side effect of SSRIs, especially sertraline, known as Zoloft, and escitalopram, better known as Cipralex, is a decrease in libido.About 20-30% of people taking antidepressants from this group experience a decrease in sexual desire to one degree or another. At the same time, it is difficult to say how the drugs are to blame, because about 35-50% of people with depression have already experienced sexual dysfunctions.

Many people with depression experience sexual dysfunction before taking antidepressants – Harvard Medical School Bulletin

Changing the antidepressant to another usually helps, but many people prefer to wait until the medication can be withdrawn.In some cases, psychiatrists prescribe antidepressants from other groups in addition to an antidepressant to lower libido. Sometimes it helps to restore interest in sex.

Myth 7

They get fat due to antidepressants

This is not a myth, but a half-truth. There are antidepressants that promote weight gain as well as those that do not.

Most often, people taking the tetracyclic antidepressant mirtazapine complain of an increase in body weight during treatment – it really increases appetite.Another weight-promoting antidepressant is paroxetine, more commonly known as Paxil. But “Zoloft” and “Tsipralex” do not contribute to weight gain.

If the patient feels that the antidepressant is causing him to overeat, it makes sense to consult a doctor and discuss a replacement drug.

Myth 8

Antidepressants are expensive

This is true, but not for all patients. Most people can cure depression without going broke.

Antidepressants from different groups vary greatly in price. Among them there are very expensive drugs and relatively budget drugs. At the same time, both of them work equally well. However, there are situations when you can’t get by with a cheap antidepressant.

On the left – inexpensive Zoloft for 327 R, a medication based on sertraline, on the right – the most expensive antidepressant Ixel based on milnacipran for 2453 R

For example, there is a good antidepressant, venlafaxine. The maximum dose of venlafaxine can be up to 375 mg per day.If these are inexpensive pills of a domestic manufacturer, then a course of treatment for a month costs about 2000 R. But sometimes inexpensive pills are not very well tolerated: they cause headache, nausea, sweating, tachycardia, that is, palpitations. In such cases, you need to switch to the prolonged form of venlafaxine – “Venlafaxine Retard”, or “Velaxin XR”. But this drug is more expensive: the course of treatment will cost about 5000 R per month.

The cost of a course of treatment with another good drug, Ixelom, based on milnacipran, which is tolerated with minimal side effects, can go up to 12,500 R.But, unfortunately, there is nothing to replace it, because this medicine does not yet have generics.

For comparison: on the left is a drug based on venlafaxine with an immediate release for 443 R, on the right – with a delayed one at the same dosage for 1756 R. The price varies very much 90,000 Is it true that antidepressants make you fat?

Weight gain is a possible side effect of many antidepressants, but not all. Plus, everyone reacts differently to antidepressants, with some people gaining weight and others not.

Why antidepressants cause weight gain is still not clear. Some drugs are known to be more likely to cause weight gain than others. These include the following:

Tricyclic and tetracyclic antidepressants such as amitriptyline, imipramine, and doxepin. They are used less frequently than SSRIs because they have more side effects. Among them are constipation, drowsiness, weight gain.

Monoamine oxidase inhibitors such as phenelzine (nardil).They have many side effects, including weight gain. Those who take them have to avoid certain medications and foods, such as cheeses, sausages, soy, and other foods high in tyramine and tyrosine.

Atypical antidepressants are medicines that are not classified in other groups. One of them, mirtazapine (remron), increases appetite and promotes weight gain.

Not all drugs in these categories cause weight gain.For example, bupropion, an atypical antidepressant, does not have this side effect.

Weight is influenced not only by antidepressants, but also by a person’s condition.

The symptoms of depression in humans are manifested in different ways. For example, someone overeats, so they gain weight. Someone, on the contrary, does not want to eat – and he loses weight. And then he starts taking antidepressants, because of this, his mood improves, an appetite appears, which leads to natural weight gain.

Sometimes weight gain has nothing to do with depression or medication.Adults tend to get better with age.

People with depression often experience lifestyle changes. You lose strength for sports, walks, it’s hard even to get yourself out of bed. If there are fewer activities and more food, then the weight can increase. Because a person consumes more calories than they burn during the day.

9 reviews, instructions for use

	05/02/21 20:23:09 According to the WFSBP clinical guidelines, sertraline has evidence category A and recommendation level 1 for the treatment of panic disorder and agoraphobia, generalized anxiety, social anxious, obsessive-compulsive, post-traumatic, unipolar depressive disorders.According to a 2018 meta-analysis by A. Cipriani, sertraline is one of the best antidepressants in terms of tolerability. Like other drugs from the SSRI group, it often causes nausea (24%), headache (21%), insomnia (19%), diarrhea (18%), dry mouth (14%), drowsiness in the first 2 weeks (13%), increased fatigue (10%), dizziness (11%), increased anxiety, nervousness, panic attacks (see the instructions for “zoloft”, the original sertraline). Usually, these side effects quickly disappear with continued therapy, but exceptions are possible.Especially such symptoms often become the reason for refusal of treatment in persons suffering from panic, hypochondriacal or somatoform disorders. Also, the drug during therapy can cause ejaculation disorders (14%). Sertraline is one of the most commonly prescribed drugs in my practice. It has wide indications for use, a high category of evidence, in most cases – good tolerance. According to NICE, it is recommended for use in people with cardiovascular diseases.One of the most affordable antidepressants and perhaps the best in terms of price / quality.
	02.02.21 12:52:02 Well studied. High safety criterion. A wide range of disorders in which it shows good results. Great for treating anxiety and depression. In some patients it caused a decrease in libido, which is especially uncomfortable for people living an active sex life. A frequent occurrence at the beginning of the admission is nausea, which is why some refused to continue the admission, but this is an individual matter. The drug is really good in terms of efficacy, safety, value for money.
	01/08/21 07:00:43 Refers to SSRI drugs. The effect of therapy may already occur in the first two weeks of admission. The drug is quite effective in depressive episodes, some anxiety disorders. The minimum number of side effects with high efficiency. In the first days of reception, the alarm can be amplified.
	09/21/19 15:01:40 I like the rather pronounced antidepressant effect. Also observed sedative, weak stimulating. Suitable for the treatment of severe, atypical depression. Also with masked depression, overeating. Rare, comparable to other drugs in this group. I prescribe quite often, I consider it an effective and proven representative of the SSRI group.
	10.09.19 09:50:01 Sertraline is an antidepressant used to treat major depressive and anxiety disorders. Belongs to a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). It affects the level of serotonin in the brain. The appearance of irritability, anxiety, agitation, hostility, aggressiveness, suicidal tendencies is possible, if these symptoms appear, consult a doctor immediately. Weight gain can be associated with fluid retention, lack of exercise, and increased appetite. Antidepressants may increase suicidal thoughts and behavior in children, adolescents and young adults.
	05/04/19 23:46:30 An effective drug whose clinical justification has been proven in double-blind randomized trials. Long-term reception is possible. Does not cause weight gain. Good sedation with sleep correction. It does not have a negative effect on the work of the heart muscle and psychomotor activity.
	13.10.17 15:47:21 High efficiency, good thymostabilizing effect, anorexigenic effect. Could be cheaper, side effects of the sexual sphere. One of the best first-line drugs for predominantly anxiety depression, good efficacy and tolerability for long-term therapy in patients with chronic disorders.
	26.05.17 11:24:09 Refers to a balanced antidepressant, that is, it has an activating property in apathetic, melancholic depression and an anti-anxiety, sedative effect in agitated depression. Well tolerated, goes well with other psychotropic drugs. It can be taken for a long time without pronounced side effects, including without changes in weight, hormonal status. Unstable effect in generics. The first days after taking, as a rule, anxiolytic cover is required with the predominance of anxiety syndrome within the framework of depression.Moderate effect on anxiety disorder as monotherapy.
	16.02.17 19:02:30 The effect is good, acts quickly, there are very few side effects, good sedation and antidepressant effect. Effective in combination therapy for severe psychotic disorders. Does not cause an increase in body weight and lethargy, drowsiness. Patients are well tolerated and the drug is available. Long-term use is possible.

Depression

Russian Academy of Medical Sciences
SCIENTIFIC CENTER FOR MENTAL HEALTH

DEPRESSION (from hope to certainty).
(INFORMATION FOR PATIENTS AND THEIR FAMILIES)

MOSCOW
2008

Oleichik I.V. – Candidate of Medical Sciences, Leading Researcher of the Department for the Study of Endogenous Psychic Disorders and Affective States

The vast experience accumulated by mankind and reflected in many literary works convincingly shows that sadness (sadness, blues) has always gone side by side with people, being one of the natural human emotions. None of us is immune from failure, illness, breakdown of relationships, loss of loved ones, financial ruin. Each person can face something inevitable and inevitable, when it seems that life is losing its meaning, and despair becomes boundless.Normally, however, sadness, grief and longing, as natural reactions to traumatic events in the psyche, weaken over time and the person’s condition returns to normal without special treatment. The situation is different with depressions, which are mental disorders that differ from natural physiological reactions in greater intensity, special severity of experiences and persistence of manifestations. True depressions rarely go away on their own, requiring persistent, sometimes long-term treatment.
A depressive state (from the Latin word depressio – suppression, oppression) is a disease that concerns not only an individual specific sick person, but is also a significant burden of modern society, since it is spreading more and more in the world, causing tremendous damage to the health of the population and the state economy.And this applies to all countries, regardless of their level of social development. Depression affects at least 200 million people worldwide every year. Perhaps these indicators are even higher, since most victims of depression do not seek help, because they do not realize the pain of their condition. Scientists have calculated that almost one in five people who have reached adulthood suffers at least one episode of depression during their life.
In the most general sense, a depressive state is one of the possible forms of a person’s response to stressful factors.In some cases, depression can be triggered by external negative influences, for example, mental trauma, excessive training or work overload, infection or other serious somatic illness, traumatic brain injury, changes in the hormonal background, which is especially important for the female body, regular taking certain medications, such as hormones, drugs that lower blood pressure, abuse of alcohol or other drugs. In other cases, depressive conditions develop as a manifestation of such mental illnesses, in which the main effect is heredity or the characteristics of the nervous system (cyclothymia, dysthymia, manic-depressive psychosis, schizophrenia, etc.).). If, on the basis of the description of depressive symptoms set forth below in our brochure, you understand that you have really developed a depressive state, do not fall into despair, do not “try to pull yourself together,” remember that depression is not a manifestation of weakness of will or character, on the contrary, the weakening of volitional qualities is one of the main symptoms of depression. Depression is a disease like rheumatism, arthritis or hypertension, it responds well to treatment, with the result that there is almost always a complete recovery.You should not blame yourself for the occurrence of depression, it does not indicate either your fault, or your weakness, or the possible development of a more severe mental pathology. Below we will tell you about the symptoms of depression, which can be extremely varied.

Manifestations of depression

The manifestations of depression can be very different. Depressive states can be manifested by a violation of almost all aspects of mental life: mood, memory, will, activity, which is expressed in the appearance of sadness, sadness, mental and muscle inhibition, lasting at least 2 weeks.Depressed mood during depression can manifest itself as mild sadness, sadness, and boundless despair. It is often accompanied by a feeling of melancholy, unbearable heaviness on the soul, with excruciating pain behind the breastbone, a feeling of hopelessness, deep depression, hopelessness, helplessness, despair and insecurity. At the same time, the patient is completely immersed in his gloomy experiences, and external events, even the most joyful ones, do not affect him, do not affect the mood, and sometimes even worsen the latter.Anxiety of varying severity is also a constant “companion” of a depressive mood: from mild anxiety or tension to violent excitement, violence. Anxiety and bad mood arise at the mere thought of the need to make a decision or change your plans due to suddenly changed circumstances. Anxiety can also manifest itself at the physical (bodily) level in the form of belching, intestinal spasms, loose stools, frequent urination, shortness of breath, palpitations, headaches, increased sweating, etc.
The picture of depression is complemented by the disappearance of desires and interests, a pessimistic assessment of everything around him, ideas of one’s own inferiority and self-accusation. Deficiency of vital impulses manifests itself in patients with many symptoms – from lethargy, physical weakness to a state of weakness, loss of energy and complete impotence. Where an important decision is required, the choice between various options, human activity is sharply hampered. Depression sufferers are well aware of this: they complain that small everyday tasks, small issues that were previously solved almost automatically, acquire the meaning of complex, painful, insoluble problems.At the same time, a person feels that he has begun to slowly think, act and speak, notes the oppression of drives (including food and sexual instincts), suppression or loss of the instinct of self-preservation and the lack of the ability to enjoy life, up to complete indifference to what previously liked , caused positive emotions.
People with depression often feel “stupid,” “mentally retarded,” “feeble-minded.” Thinking in depression becomes viscous, painful, requires special efforts, one mental image is hardly displaced by the next.The sick person is depressed by the feeling of his own intellectual inconsistency, professional collapse. Depressed patients find it difficult to describe their painful experiences to the doctor. Only after recovering from depression, many of them say that the mood at that moment was low, thinking was slow, all undertakings (including treatment) seemed in vain, and the years they lived were empty and useless. However, at the time of the first visit to the doctor, they could not explain this because of the almost complete absence of thoughts in the head, “para-lich of thinking”.With depression, there are also often complaints about memory loss due to which those suffering from it assume that they have “Alzheimer’s disease”, “schizophrenia”, “senile dementia”, which is not true. These complaints are especially common in depression developing in adolescence.
Typical story
Alexey, 18 years old, a 1st year student at a technical university, describes his condition during a depression this way:
“Since childhood, I was fond of technology and modeling, I could read special literature for hours, I won school and regional Olympiads in mathematics and physics.After leaving school, my dream came true – I brilliantly passed the exams at a prestigious university. Then it seemed to me that the whole world was at my feet, I was flying with happiness “as if on wings.” In September I started my studies with joy. In the beginning, everything worked out well, but after 2 months I began to notice that it was more and more difficult for me to assimilate what I was reading, I did not memorize the simplest text, I could not solve the problems that I used to “click like nuts”. Attempts to achieve success with the help of many hours of “brainstorming” or drinking a few cups of coffee led to the fact that I completely ceased to think anything.It seemed to me that I was “completely and irreversibly dull.” At night, I sobbed, wrapped in a blanket and wondered how best to commit suicide. Fortunately, I met a senior in the library and shared my problems with him. A new acquaintance of mine said that he was experiencing something similar and advised me to see a psychiatrist at a student clinic. After the examination, I was diagnosed with juvenile depression and referred for treatment to a specialized medical center. After 2 months I felt completely healthy, returned to my studies and caught up with my classmates. “

Depression can also be accompanied by real setbacks: for example, decreased academic performance, quality of work, family conflicts, sexual disorders and their consequences for personal relationships. As a rule, the significance of these failures is exaggerated and, as a result, there is a false sense of the irreparability of what happened, “the collapse of all hopes.”
Another generally recognized danger of depression is the possibility of suicidal thoughts, which often lead to suicide attempts. The condition of a person suffering from depression can suddenly deteriorate sharply, which happens either without clear external reasons, or under the influence of traumatic situations, unpleasant news.It was at these hours, and sometimes even minutes, that the fateful decision was made. Factors that increase the risk of suicide in depression are past suicide attempts, the severity and duration of the depressive state, the presence of anxiety in its structure, prolonged insomnia, loneliness or alienation in the family, alcohol and drug abuse, loss of work and a sharp change in lifestyle, as well as suicides by relatives.
Typical history
Evgeniy E., 35 years old, leading manager of the company.
Almost all my life my career went “upward”, the goals set were clear-cut, clear and achievable. The marriage was extremely harmonious, two beloved children grew up. He devoted almost all his time to the business of the company, occasionally, once every 1-2 months, he and his family broke out of the city, to the dacha. He often did not sleep enough, stayed late at work, took home assignments, was deeply worried about the affairs of the company. Gradually, irritability, fatigue, insomnia, difficulties in concentration appeared, more and more often he suffered a “fiasco” in his intimate life.There were thoughts that life was lived in vain, that it was a “chain of tragic mistakes” that led to a dead end. He began to believe that the choice of work, friends, family was wrong, for which now “the reckoning has come.” Analyzing the past years for a long time, I found more and more evidence and examples of my “duplicity, hypocrisy, insincerity, etc.” I realized that the only way to solve all the problems is voluntary withdrawal from life. At the same time, he believed that by this act he would free the family from the “burden”, “loser”, “loser”.I decided to lock myself in the garage and poison myself with the exhaust gases of the car. However, by chance, in a semi-conscious state, he was discovered by an employee of a garage cooperative. He explained the incident as “an unfortunate incident.” The thought of leaving this life did not leave the patient. I decided to shoot myself from a gas pis-tolet, which I had acquired long ago for self-defense. After being shot in the mouth, in a difficult state, he was taken to the N.N. Sklifasovsky, from where he was discharged a week later. The alarmed wife, suspecting something was wrong, decided to consult her husband at the psycho-atra.Was admitted to the clinic. He agreed to this only out of respect for family relations, he himself believed that treatment by psychiatrists was completely useless, because his position is hopeless and no medicine will help here, but only “intoxicate” his psyche. However, after two weeks of taking a modern antidepressant drug, the patient’s point of view changed. Everything began to look not so bleak and hopeless, interest in work and life in general returned, began to feel more cheerful, more energetic, an interest in intimate life appeared.He took work to the clinic, called up with colleagues. After two months of treatment, he completely returned to his usual life. With bewilderment, he recalled his reflections on insolvency, the collapse of life, and suicide. He took the drug prophylactically for about six months, then, on the recommendation of a doctor, gradually reduced the dose and stopped taking it. Over the next two years, the state remained stable, career growth continued, and another child was born.

Depression is also characterized by sleep disturbances, which are observed in approximately 80% of patients.As a rule, these are early awakenings with the inability to fall asleep, lack of a sense of sleep, difficulty falling asleep. These disorders, as well as restless sleep with unpleasant dreams, are often the very first symptoms of onset depression.
If the depressive state is shallow, it is sometimes difficult to recognize it. This is due to the fact that people are ashamed to tell others about their problems, to admit their “weaknesses”. Quite often, especially in Russia, depressive states are masked by alcohol abuse (“vodka heals”).In addition, often patients suffering from depression, in order to “shake themselves,” “throw themselves out of trouble,” engage in casual sex, are addicted to gambling or extreme sports, leave to serve under a contract in “hot spots”, an idle lifestyle with constant attendance at entertainment events. People around them, relatives who do not have psychiatric knowledge, often accuse them of debauchery, drunkenness, a riotous lifestyle, parasitism. Meanwhile, this behavior is a kind of “cry for help”, an attempt with new acquaintances and impressions to fill the spiritual emptiness introduced by depression.
Depressive states can occur in shallow forms that are easily treatable, but at least a third of depressions are more severe. Such depressions are characterized by:
– ideas of guilt, sometimes reaching the degree of delirium, i.e. unshakable conviction of their sinfulness, of little value (patients consider themselves to be great sinners, they believe that all relatives and Humanity will die because of them, that they are “moral monsters” from birth, allegedly devoid of the foundations of morality and feelings of empathy for other people that they have no place on earth.They find in their past numerous “confirmations” of the above, believe that the doctor and other patients are aware of these sins and express contempt and indignation with their facial expressions and gestures, but in words they “hide, deny the obvious.” This must be remembered by both the sick and their loved ones in order to prevent the impending threat in time: remove all firearms, stabbing and cutting objects, ropes, potent medicines and poisonous household liquids, close windows or shutters, do not let the sick one go anywhere.If these ideas become persistent and cannot be dissuaded, it is necessary to urgently seek advice from a neuropsychiatric institution or call a psychiatrist at home.
– mood swings during the day: in typical cases, the patient, waking up, immediately feels melancholy. Sometimes, even before full awakening, through a dream, he experiences a grave premonition of a difficult coming morning. In the evening, the state of health improves somewhat.
– the patient may experience a feeling of unmotivated hostility to relatives, friends, constant internal discontent and irritation, which makes him unbearable for the family.
– for a number of people suffering from depression, constant doubts come to the fore, fear for the health and well-being of loved ones, obsessive, i.e. arising without will, ideas about the misfortunes and troubles of family members.

Typical history
Dmitry Petrovich, 58 years old, teacher.
“After some minor troubles at work, I began to feel incomprehensible anxiety and agitation. Unpleasant thoughts crept into my head that I did something wrong at work, which is why I rechecked everything many times and went home later than everyone else.But even at home, the alarm did not let go: as soon as the daughter or wife lingered for at least half an hour, terrible pictures of traffic accidents or violence were drawn in imagination. I fell asleep only in the morning, got up broken and felt sleepy all day. I took Valeria, well, Corvalol, but it practically did not help. At work, they hinted if I might take a vacation. Friends advised to contact a neurologist, but he did not find his pathology and referred to a psychiatrist. I was diagnosed with anxiety depression.After a course of outpatient treatment, I completely recovered. ”

– in many cases, depression is characterized by unpleasant sensations in the body, disturbances in the activity of internal organs in the absence of objective signs of a true somatic, i.e. not related to the psyche of the disease. At the same time, many patients constantly note pain and internal discomfort. Some complain of headache, pain in the stomach, joints, lower back, others – on disorders in the work of the intestines: constipation, indigestion, irritation of the colon, while others pay attention to a decrease in sex drive and potency.In women, menstruation often becomes painful and irregular. Approximately 50% of depressed people at the doctor’s appointment complain of similar physical ailments, without mentioning the depressed mood or state of mind that underlies depression. Experiencing chronic pain or other unpleasant sensations in the body, patients may not even realize that they are suffering from depression, even with severe melancholy, considering the latter a reaction to painful bodily discomfort.
– some patients are convinced that they have some rare and difficult to diagnose disease and insist on numerous examinations in general medical institutions.Doctors call this condition masked (hidden) depression, in which a person may experience pain in the head, in the limbs, behind the sternum, in the abdomen and in any other parts of the body, he may be haunted by anxiety, he may suffer from insomnia, or, on the contrary, sleeping too much.
– patients may experience disturbances in the cardiovascular system, itching or lack of appetite may appear. And all these are manifestations of depression.
– the pathological sensations that patients experience with such depressions are quite real, painful, but they are the result of a special mental state, and not an internal illness.It must be remembered that the frequency of latent depressions exceeds the number of obvious ones many times.
– with such depressions in patients, as a rule, the attitude to food is also changed: they can go without food for a long time and not feel hunger, and sitting down at the table, eat only 1-2 tablespoons – they have neither the strength nor the desire for more …
– a sign of depression can be a weight loss of more than 5 kg. within a month. In some people, especially in women, appetite during depression, on the contrary, increases, sometimes reaching the level of excruciating hunger, accompanied by severe weakness and pain in the epigastric region.In some cases, food is taken in excess due to an increased desire for sweets or attempts to distract oneself from painful thoughts through frequent meals.
Thus, we see that depression is a disease with many different manifestations that do not go away by themselves, requiring special, sometimes long-term, medical intervention. Therefore, when the above symptoms appear, it is necessary to seek help from a psychiatrist, who will prescribe and control antidepressant treatment.

TREATMENT OF DEPRESSIVE DISORDERS

By now, it can be argued that the vast majority of cases of depression respond well to treatment. According to modern views, effective treatment of depression consists of a combination of pharmacotherapy, psychotherapy and, if necessary, other types of treatment. At the same time, the main role in therapy, of course, belongs to antidepressants – drugs specially developed for the treatment of various types of depression.
The creation of antidepressants is based on the discovery of scientists that depression develops as a result of a violation of the mechanism of biochemical transmission of nerve impulses in the brain regions responsible for mood, behavior, stress response, sleep and wakefulness, appetite and some other functions. To ensure the coordination of the work of all these functional units, the brain sends special “commands” to them in the form of chemical impulses transmitted from the processes of one nerve cell (neuron) to the processes of another.This transmission is carried out with the help of chemical messengers (neurotransmitters), which, after transmitting a signal, partially return to the original neuron. This process is called transceiver pickup. Thanks to him, the number of mediators in the microscopic space between the processes of neurons (in the so-called synaptic cleft) decreases, which means that the necessary signals are transmitted worse. Numerous studies have shown that various neurotransmitters, in particular, norepinephrine and serotonin, are involved in the transmission of signals that ensure the normal functioning of the nervous system.The first of them has a general activating effect, maintains the level of wakefulness of the body and takes part in the formation of adaptive reactions, and the second has the main antidepressant effect, controls impulsive actions, anxiety, aggressiveness, sexual behavior, falling asleep, feeling of pain, therefore serotonin is called sometimes a regulator of “good mood”. A decrease in the number of neurotransmitters in the synaptic cleft causes symptoms of depression, while an increase, on the contrary, prevents their appearance.The ability of some drugs to in one way or another increase the concentration of mediators in the synaptic cleft allows them to be used as antidepressants.
Now in Russia antidepressants are used, which can be conditionally divided by the time of creation into 4 generations.
The first antidepressants to find wide clinical use were drugs of the tricyclic structure: amitriptyline and imipramine. They have a rather powerful effect on most depressive conditions by blocking the reuptake of both norepinephrine and serotonin.However, the real clinical effect of these drugs is significantly leveled by their unwanted side effects, which sharply reduce the quality of life of patients during treatment. Side effects of tricyclic antidepressants arise due to the non-specificity of their effect on receptor structures. Acting in addition to the serotonin and norepinephrine system and on other neurotransmitters (acetylcholine, histamine, dopamine), these antidepressants cause side effects such as urinary retention, dry mucous membranes, constipation, heart palpitations, fluctuations in blood pressure, confusion, tremors, sexual disorders function, weight gain.In such cases, it is necessary to prescribe other drugs to correct side effects or to reduce the therapeutic dose of drugs, which naturally affects the effectiveness of the antidepressant action. It has been noticed that up to 50% of patients refuse to take tricyclic antidepressants due to pronounced side effects. For the same reason, doctors are less and less likely to prescribe these drugs to patients on an outpatient basis.
The situation was somewhat improved by the introduction into practice of drugs of the second generation – tetracyclic antidepressants, which, along with the ability to block the reuptake of norepinephrine and serotonin, could act on some other receptors.Being analogs of tricyclic compounds, these drugs have comparable antidepressant activity, but unlike their predecessors, they are safer, since they cause unwanted side effects much less often. In addition to the antidepressant, mianserin (lerivon) has a clear sedative, anti-anxiety and hypnotic effect. Maprotiline (lyudiamil) has a mild balanced antidepressant effect. In general, these drugs are able to treat mild to moderate depression, but are ineffective in patients with severe depression.
Such antidepressants of the 3rd generation as fluoxetine (Prozac), fluvoxamine (fevarin), paroxetine (Paxil), sertraline (zoloft), citalopram (cipralex) and some other drugs that selectively (selectively) affect the serotonin metabolism system have received widespread recognition. , preventing its reuptake in the synaptic cleft. Based on the mechanism of action, these antidepressants are combined into the group of selective serotonin reuptake inhibitors. In addition to treating depression, they are used to correct eating disorders, neutralize panic disorders, the so-called social phobias, various obsessions and chronic pain symptoms.These drugs have gained popularity due to the possibility of taking once a day, the accompanying anti-anxiety action, the presence of a psychostimulating component and a small number of side effects. In addition, they have low toxicity and are well tolerated by elderly patients. However, some researchers note their insufficient effectiveness in the treatment of severe forms of depressive conditions, probably associated with selective activity in relation to only one neurotransmitter – serotonin.It should be noted that in recent years, some American scientists have associated the use of these drugs with an increased suicidal risk, which, however, has not been proven.
Given the high frequency of side effects in some of the above drugs and insufficient antidepressant activity in others, psychopharmacologists have taken the path of developing more effective antidepressants – IV generation drugs that selectively block the reuptake of both serotonin and norepinephrine, without affecting other mediator system and having minor side effects.These requirements are currently met by 3 drugs: milnacipran (ixel), duloxetine (simbalta) and venlafaxine (effexor). Their antidepressant activity in the treatment of patients with severe and moderate depression has been confirmed in a number of specially conducted studies, which simultaneously showed that these drugs are well tolerated.
It should be noted that antidepressants of plant origin (nagrustin, gelarium hypericum, deprim, etc.) can be effective in case of shallow depressive conditions.), but there is no reliable data to guarantee their validity. The opinion of a number of doctors that all depression can be treated with herbs or, say, acupuncture, should be considered unfounded.
For extremely severe depression, which does not go away despite the use of the most powerful antidepressants, electro-seizure therapy (ECT) can be effective, but this situation is extremely rare and requires careful justification by a panel of doctors and the patient’s consent.
An important additional role in antidepressant therapy, especially with concomitant anxiety, is played by tranquilizers – anti-anxiety drugs such as Xanax, Phenazepam, Diazepam, Nitrazepam, Atarax, etc.The drugs that, when taken regularly, prevent mood swings in various depressive disorders, include the so-called normotimics or mood stabilizers – lithium preparations, carbamazepine, valproic acid salts, lamotrigine, topiramate. With their systematic intake in most patients, the clinical manifestations of depression either completely disappear, or become rare and mild, do not require hospitalization and do not significantly affect the ability to work.
Antipsychotics play a prominent role in the treatment of some forms of depression. These include both traditional drugs – fluanksol, triftazin, eglonil, teralen, neuleptil, sonapax, and atypical antipsychotics that are gaining increasing recognition among doctors: seroquel, solian, zeldox, rispolept, abilify, sardolect and others.
In the drug therapy of depressive conditions, an unconventional, strictly individual approach is used, with the obligatory provision of fruitful cooperation between the patient and the doctor.Otherwise, there may be a violation of medical recommendations in relation to doses and regimen of medications. The patient’s faith in the possibility of recovery, the absence of prejudice against the “harm” caused by psychotropic drugs, systematic adherence to the prescribed doctor’s prescriptions largely contribute to the achievement of therapeutic success.
Medication for depression takes time. You should not wait for a complete cure already in the first days of taking the drug.It must be remembered that all modern antidepressants begin to act on depressive symptoms no earlier than 1-2 weeks after the start of treatment. Cancellation of the antidepressant, as well as its appointment, should be carried out only by a doctor. Cancellation is usually made no earlier than 6 months from the normalization of the mental state. Even after the complete disappearance of all symptoms of depression, do not rush to stop taking the drug on your own, as there is a risk of exacerbation of the disease. Therefore, doctors recommend that you continue taking the antidepressant for a certain period of time.A common mistake is to prematurely discontinue medications soon after a significant improvement in the condition or due to “forgetfulness”. To avoid this, try to include the drug in your daily emergency list – for example, store it in the bathroom and take it after doing hygiene. When going on a trip, calculate exactly how many pills you need for the entire period of absence from home. The interruption of therapy is fraught with serious troubles.
Psychotherapy of patients with depressive conditions, carried out along with drug treatment, implies various systems of influence, including individual conversations, family and group therapy, etc.An important element of social rehabilitation is participation in the work of mutual support groups for patients with depression. This allows the rest of the patients to feel help in understanding their problems, to realize that they are not alone in their misfortune, to see the possibilities of personal participation in rehabilitation activities and in public life.

What we are treated with: Reduksin. What is losing weight – a person or his wallet?

The SCOUT study (Sibutramine Cardiovascular OUTcomes – cardiovascular outcomes after taking sibutramine) on 10,742 patients with obesity and cardiovascular diseases showed that this drug increases the risk of sudden death, heart attack, cardiac arrest.Because of it, sibutramine was even banned in many countries, including the USA, Canada, Australia, the EU, and the UK. Does this mean that everyone needs to immediately stop taking the drug? This is still a reason for discussion, and in healthy patients the issue of increased risks remains open. In addition, everyone’s favorite ibuprofen and other non-steroidal anti-inflammatory drugs also increase these risks, but they have not been canceled. On the other hand, pain in medicine is a more pressing problem than obesity, and if a large part of the “audience” of sibutramine can choose a healthier diet and sign up for the gym, such simple methods will not help those suffering from pain.

The saddest situation occurs when sibutramine is illegally added to herbal extracts, where, according to the composition, it should not be. Then a magical bunch of hay will work and sell well, but in this case, the doctor will not be able to comply with the dosage, nor determine with which medications the miracle supplement cannot be combined, nor will the doctor be able to protect people with cardiovascular diseases from complications.