Which SSRI to take? CANNOT gain weight!

[fearfactor]

Hi, I am 33 years old, female, 28 weeks pregnant with 2nd child.  I just graduated from a top 10 law school, am studying for the bar, living a VERY stressful life.  I cannot seem to concentrate on my bar preparations, feel distracted all the time, very lethargic, hopeless and depressed.  I know it seems I may have a lot going for me, but my family is undergoing financial problems and it worries me a lot.  My husband works a job that doesn't cover our bills and our savings are dwindling.  I can't work because of bar study and then will be off having the baby - I do intend to do temp work between the bar and my due date in late August.  I feel like things will never get better for us a lot and I wake in the night terrified and thinking about my future.  It takes me a long time to go back to sleep and this results in my being exhausted and even more distracted the next day.  I am seeing a psychiatrist who has recommended that I go on an antidepressant 2 weeks before my baby's birth because I had postpartum depression after my last child's birth.  I am thinking I may want to try and go on it now instead because of the way I'm feeling.  

My main problem is the fact that I have severe body image issues and was near suicidal after my last childbirth because it took me a long time to lose the baby weight.  I have controlled my weight gain during this pregnancy and absolutely, positively CAN'T put on weight from an SSRI.  That is the only thing keeping me off SSRIs (besides the fear of withdrawal for the baby, of course).  I'm scared if I get on an SSRI I will gain weight and/or not be able to lose the baby weight.  This will only lead to more problems for me.  I am already at a disadvantage in finding a job because of the fact that I'm 33 (older than the average law grad) and have a family.  I can't be fat and give off an even worse image.  

Can you tell me which SSRI is least likely to cause weight gain?  I have anxiety and sleeping problems so I don't want to get on something that's activating - I took Effexor and Wellbutrin for a while and had horrific anxiety on both.  Also, if I get on an SSRI now at 28 weeks, should the withdrawals be horrible for my baby when she's born?  I don't want her to go thru SSRI withdrawal because I know myself how bad it can be.

Thank you.

[Roger Gould, M.D.]

Since you are seeing a psychiatrist who knows you so much better than I could in this forum, it would be inappropriate for me to do anything but warn you about the dangers. Ask your psychiatrist about recent suggestions that ssri's in pregnancy are potentially more harmful at this stage than had been thought.  You will want to be very cautious now, but may be all right in the two weeks before birth.

All ssri's have potential weight problems in around 10% of people who use them, and you can't be sure whether you will be in that 10% or not without a trial.

Since much of what you describe is anxiety, why don't you try something like klonopin before bed time. It will also help you sleep.

If weight becomes a problem because of emotional eating, you can go to www. masteringfood.com.

[ihatepvc's]

I can't tell you which ssri causes the least amount of weight gain, but I can tell you that Paxil is one of the worst for weight gain. I had a tough time losing the weight from it although it does eventually seem to come off months after you get off of it. I read that Zoloft is not as bad and have a friend who has taken it for a few years now with no weight gain. Any way you could hold off on taking it though until after the baby is born? Remember that once you start practicing as an attorney you will have a good amount of extra income coming in. My husband is an attorney and at first we were struggling with many financial problems and a huge amount of debt (almost $200k). His income increased yearly (although it seemed like it would never happen!) however, and we are at a really good place now. You have to believe it will happen and more imprortantly, make it happen. I'm not pregnant now but recently went through a depression and what helped me out of it was exercise and reading a book that said that the key to happiness is not in self-fulfillment, but in helping others. Basically look outwards and do for others, rather than focus on yourself. It made a lot of sense because I couldn't understand why with a great husband, interesting job, beautiful kids and finally buying my dream home I didn't feel happy or fulfilled. It was kind of a relief for me to forget about myself for a change and concentrate on other people. It's called "The Good Life" and you can get it on Amazon.com. As for weight gain, have you tried "the Zone"? this is a healthy way to eat that is not depriving in any way. My friend recently lost 15 pounds on it and says that she actually feels like she eats too much on it. Good luck to you and please think about your bright future!

[ihatepvc's]

By the way, my husband was "older" too when he graduated from law school. He was 35 when he passed his bar and now he is a partner at a major law firm in Manhattan and is in charge of hiring for his group. Remember that you may be older than others, but you will also be wiser. My husband tells me stories about these young associates and many of them are spoiled with no work ethic at all. It's a big problem. They expect to be paid alot of money because they went to good schools but don't feel they need to work for their salary and have attitudes on top of it. 'Older", more experienced associates, especially from good law schools might be seen as more more attractive to employers. Be confident! I like to remind myself of what Dr. Phil always says "get excited about your life!".

[fearfactor]

Thanks for the encouragement and the book recommendation!  It is hard for me to think of things positively because I am terrified I won't be able to succeed.  Thanks for the story about your husband - I hope that I can be that successful one day.  Thankfully, we don't have too much debt even though my school was very expensive.  I guess I do have an edge over those young associates - I just have to find a firm or agency that believes that, too.  I am trusting God and hoping I will be able to do that.  BTW, I also have PVCs, too!  Thankfully, they have been lots better during this pregnancy and I hope that continues.  Stress definitely contributes and I can't imagine taking the bar with my PVCs going crazy! :)

[ihatepvc's]

I thought you sounded familiar from the heart forum. Actually, I was looking on this forum because I was thinking about taking some sort of anti-anxiety med for the pvc's but like you, do not want to gain weight. The weight I gained from Paxil was very stubborn and slow to come off. I just want to tell you that at 41, I finally understand that anyone can be successful, you just have to make it happen. It's just the desire to do it and will power and if you want to succeed, you will. There's no questions or mystery there. If you are honest and work hard, people will notice and appreciate it and in the end you will be rewarded for it. I wish I would have had faith back then that someday things would get better financially, but I didn't. It's hard to look ahead positively when things look so bleak. I was actually was thinking of having a fourth child, but I am getting older, plus I'm afraid of my pvc's getting really bad and then not being able to take my Propranolol. I'm happy for you that you are getting a break from them. Everything will fall into place, you'll see. Good luck with everything!

[shade]

Hi

You may want to check out the question I posted.  It's titled:  Real talk about antidepressant weight gain.  I posted it somewhere around May 15.  There are nearly forty comments as of today.

Too bad wellbutrin wasn't good for you.  Most (not all) on my post seemed to think it was the best choice.  I wonder if it would be better for you if you were just on wb, w/o Effexor.

My weight gain combo=effexor w/lithium.  My doctor has just added a tiny amount 5mgs of ritalin.  In combination with a strict 1400 calorie diet where I measure everything and get a lot of exercise, I've lost 5 lbs. since early June.  I had never been able to lose a single pound while on antidepressants before.  More of my story is on my post.

[fearfactor]

Thanks for letting me know about that discussion, it was helpful.  I guess I will just try WEllbutrin again (I was taking it by itself, not with Effexor - I tried both of them separately but I think the doctor started me out on way too high of a dose of Wellbutrin and that may have caused the bad anxiety.  He started me on 150 mg twice a day which is WAY too big a dose to begin with!).  If I can't take Wellbutrin I guess I will just live with the depression or try some other ways to cope with it besides meds.

[JOGIRL423]

Hi,

I wanted to say "YOU GO GIRL!" It takes a lot of guts, hard work and determination to accomplish what you have. Please do not think that because you are older you will not be wanted in the legal field or any field for that matter.

You have what employers want...life experience AND education! Someone posted about the younger grads wanting more and more...well, I would have to agree...I was raised in a world where dinner at McDonalds happened when Mom and Dad had a little extra money and I had been good as gold all week...not like today when it is a substitute for a family dinner too many nights a week.

I just turned 36 and I quit my well paying job to run a non profit group that I believe very strongly in...I work about 14 hours a day for no pay...but I would not trade it for the world.

I tell everyone who asks...if I didnt want and absoluetly love to do this you could NOT pay me any amount of money to do it...

Some day maybe I will take a salary...till then I will be helping those who can not speak for themselves against the abuse and neglect imposed on them by uncaring individuals.

You WILL succeed...my Aunt-in-law took the bar exam at 48 after having her 5th and 6th children (twin boys) at age 42...there is no age limit anymore...50 - 55 is the new 30...live it up...

Good Luck and let us know when you pass!
Jogirl

[mchris]

I have been on Prozac and have actually lost weight on it.  I know everyone's mileage varies but that has been my experience, and I have had no other unpleasant side effects.

[susandeeesq612]

Your story sounded so much like mine of 15 years ago that I had to respond.  I took the bar in 95 - I had an 18 month old, a 3 year old and a 4 year old when I started school.  I went to law school at night and took care of my kids during the day.  I also suffered from PPD with each delivery though it improved each time since I knew what to expect.  We were also going through legal and financial challenges which can create horrid depression and anxiety. Believe it or not, your life skills make you very valuable to many law firms.  I ended up getting a job at a big Philadelphia firm and one of the things they like was that I had a realistic view of life and I wasn't just another punk law school graduate who thought way too much of themselves.  Keep the faith - there are great opportunities for you.  I didn't worry about the weight so much except that I didn't like my wardrobe!  There is hope - you will be successful.  I found Prozac to be helpful.  I have and had very severe anxiety and depression - and I am a wee bit obsessive.  The Prozac worked well and did not cause weight gain in me.  Your OBGYN can talk to you about what you can take prior to delivery, I wouldn't take anything like Wellbutrin because your hormones are sort of out of whack for a month or so - xanax worked for me too and in low dosages I could still nurse.  I hope this helps.  You are a strong woman, obviously.  Don't fret - you will overcome!  Remember, take time to enjoy your children.