Should I go ahead with my therapist advice?

[yoganut]

Hello all:

I've suffered on and off all my adult life with depression. I think my father also suffered without being diagnosed.
2 years ago, due to relationship problems with my family and also my fiance, I suffered what I consider a breakdown and was put on Paxil. It did seem to help after about 2 months. However, after about 6-8 I noticed that they did not seem to be 'working' anymore.
I've been in therapy on and off for the past 16 months. My therapist has been urging me to consider going back on antideppresants, although I have resisted, partly cos it was so awful tapering off Paxil and also because Paxil seemed to cause me to put on about 15lbs, and I have never had a weight problem in the past.
She mentioned Wellbutrin to me at my last session, as I had just lost my job and was feeling very down. I can still eat (over-eat) but I have been feeling like I'm just going through the motions of life. I have been offered another job , which has caused me to feel a bit better about things, and my husband is supportive, even though we have had our problems (major ones).
My question is: I can't see my doctor til next week. I do feel slightly better about life than I have been feeling, but it seems that it doesn't take much for me to 'slip' into the blues. Is it worth going on antidepressants while I continue my therapy? Also wellbutrin is supposed to have a low risk of weight gain - does that mean that many people still put on weight? That in itself is very depressing, especially for someone like me who has never had to worry about putting one weight.
Thank you in advance.

[Roger Gould, M.D.]

This is a matter of judgement, so let me tell you my prejudice as you make up your mind.  If you are working in therapy, talking things through and solving problems, including the ones with your husband and your job, is what is going to bring you out of the blues...medication won't solve problems, it only helps temporize, and they all have side effects.  wellbutrin is much less likely to cause weight gain, but a few people do.  it is much easier to get off of if you do go on it...

[Try_to_be_social]

You had dysthymia all your adult life and Major Depressive Disorder for 2 years and psychotherapy for 16 months and Paxel working for the first 2 months only. Your weight gain is due to Paxel and possibly partially treated depression. In order to achieve full recovery of depression your best treatment is pyschotherapy together with an antidepressant. Wellbutrin is your best choice and hopefully it will work for you, otherwise you have to try another antidepressant. And you have to take the combination therapy for a long period, because of your long history of your conditions, to prevent future recurrence.

[3rdMajor]

Which is the priority, the depression or the weight?
Wellbutrin is the FAV antidepressant of weight conscious women, but it is not the appropriate antidepressant for all subtypes of depression.  Wellbutrin is an "energizing" type of AD.  It would be appropriate for depression which exhibits hypersomnia and lethargy.  If your depression features insomnia and anxiety, it is likely that Wellbutrin will exacerbate your symptoms. But, you might lose a few pounds for your suffering.