QUESTION:
Dear Dr. Heller,
I am a 35 year old female who has suffered from depression since 18 years of age and treated with pharmaceuticals since my mid twenties. I have been on many types of antidepressants except for the MAOI’s and tricyclics. At age 29 and following the birth of my twins 3 months prematurely I became devastatingly depressed. It was a gradual decline that took 10 months before things became critical and required hospitalization. That is when I was put on Effexor and it saved my life, literally. Within 2 weeks I was feeling tons better. Within 6 months I was able to return to work.
I have been on the Effexor for 6 straight years now and have never felt better except for the years prior to 18 y/o. BUT…I have gained almost ONE HUNDRED POUNDS! It is so hard to keep my head above water mood-wise when my weight has spiraled, despite my eating habits. I do experience the usual side effects which at times can be troublesome but not so much so that I have wanted to be off the drug. I have trouble falling asleep at night, and when I do fall asleep I do not move at all – which makes me very stiff and sore when I wake. I have terrible somnolence to the point that I’m sure I could fall asleep walking in the corridors at work, or fall asleep talking to someone. This side effect eases considerably after I have been awake for about 6 hours. But when I have it, it is absolutely uncontrollable drowsiness. I yawn constantly. At the onset of treatment I felt like I had a potato in my throat and had to sleep sitting upright and chew gum even in my sleep. That side effect subsided but occasionally resurfaces for no reason at all.
The only other side effect I’ve had all through the six years has been chronic gastric reflux. This has been more or less troublesome at varying times, but over the counter antacids and acid blocking agents have worked well for me. I also believe the sensation of having a potato in my throat is a referred sensation from the gastric reflux because antacid also would relieve some of the sensation in my throat. I must add that one of the side effects that was positive for me was the anti-anxiety properties of the drug. I have suffered from social anxiety my whole life, and in my profession as a nurse (15 years), I have to speak in front of my peers on multi-disciplines. I’ve always had a sensation of “dying inside” when I have to speak, even to close acquaintances and family, but more so in group situations whether or not I know the listeners. One day about a year ago, I suddenly realized I was no longer “dying inside” when I was forced to speak. I still get nervous, but I imagine it to be a “normal” degree of nervousness and not the debilitating anxiety I was always plagued with. Before it was physically painful and now it’s just a pain in the butt.
Anyway, long story short, I wanted to read your WebPage about Effexor and weight gain but I can’t seem to get to the actual page because the link at the site keeps taking me to the main index page of your website. If you could give me a direct link to the page I would be most grateful. Any other information you might be able to add would be helpful as well. I have become so discouraged with my weight that I have been considering changing medication, but I am terrified at the same time. I have been well now for 6 straight years and that is the longest period I have been well since my illness began. The thought of getting sick again in the name of weight loss is terrifying. Nonetheless, as I am 35 and not getting any younger, being 100 lbs. overweight is not a good thing.
Please help.
ANSWER:
Weight gain is a rare side effect for Effexor, and there have been no reports in the literature about this phenomenon. If this is due to the Effexor, the FDA needs to know about it. If the Effexor has caused the weight gain, then you’ll need to be treated with alternative medications. The screening test I use for my patients may give clues to additional diagnoses that might be present. Effexor treats many diagnosis, especially in high doses. Side effects are a problem. Post partum depression is often due to low thyroid – which can be worsened on rare occasions by Effexor. Getting your thyroid checked and treated if necessary is extremely important.