Cipralex and Weight Gain

Cipralex Weight Gain issues are part of one of the common topics I find in my inbox: the whole issue of whether SSRI’s make you put on weight and if so how can this be avoided. Many people have had issues with Celexa (citalopram) and weight gain, but as this personal experience shows, other SSRI’s such as Cipralex (escitalopram) can have weight gain issues.

I had a nervous breakdown 9 weeks ago, never felt that bad in my entire life…. Terrible anxiety, depression, tachycardia. I really did not want to take anti depressants as the side effects would have pushed me over the edge… I started getting a little better by myself but after 7 weeks I decided to start. My doc gave me cipralex and after only 2 days on that I felt much better, than noticed my weight had gone up by THREE kilos after 5 days on it!! Anxiety back of course. have been really watching what I eat, but the weight has not come off. I am hepatitis c positive and am scared to try duloxetine although that is the only SSRI that is good for severe anxiety/depression and has no weight gain associated with it. Duloxetine has been known to cause liver damage apparently. I am between a rock and a hard place as I need to up dosage from 5mg to 10 mg.

Sometime later this emailer followed up with:

I have been on Cipralex for 10 weeks now, and the weight gain is not such a major issue anymore, just have to watch what I eat. It has helped me a lot, I am on 20 mg now, and feeling almost back to myself. It took a while, but than I was not on the right dose. I was very ill, I’d had a mental breakdown and suffered from terrible anxiety and depression. It is worth sticking with it, at first you go up, almost as soon as starting the medication, than you seem to go down again, but you come up again as the drug accumulates in the system. Not quite like other anti depressants I have taken, but so far very helpful.

Firstly let me say how grateful I am to this person for sending me their personal experiences and allowing me to share them on this blog. It’s great that taking Cipralex has been positive and beneficial here, and I wish them all the best as they continue to recover! I think that it’s particularly interesting that weight gain hasn’t been such an issue in this case. It has long been known the SSRI’s have a tendency to cause weight gain, but not everyone suffers (indeed many SSRI’s list both weight gain and weight loss as possible side effects!).

No has a definitive answer to the question “why do SSRI’s cause weight gain?” but I have heard a theory which may have some credence. It is said that the action of SSRI’s like Cipralex on Serotonin receptors in some way causes the body to crave even more Serotonin, which it normally gets in the following way: the amino acid tryptophan enters the blood stream through consumption of foods containing the right kind of protein such as cheese, milk, fish, and meat. Tryptophan has a better chance of crossing the blood brain barrier and turning into Serotonin when it doesn’t have to vie for space with other amino acids. When you eat carbohydrate, insulin floods into your system and takes away amongst other things many of the amino acids that compete with Tryptophan for space. Tryptophan can then cross the blood-brain barrier and become Serotonin. Thus the best way to get a Serotonin hit is to eat carbohydrates (hence ice-cream can temporarily make you feel better). People on SSRI’s crave more Serotonin and therefore more carbohydrates and therefore put on more weight.

Is there something you can do about it? Probably yes, check out this post on how to avoid gaining weight on SSRI’s like Celexa, Lexapro and Prozac.

Tryptophan Anxiety Depression Cure

Tryptophan for anxiety and depression is now being touted as one of the best natural anxiety cures you can buy. It is always hard to know if something like Tryptophan is effective or not because it is not marketted by big pharma companies and is therefore not widely researched.

Hydroxytryptophan, to give it its full name, is an essential amino acid which the body cannot produce itself and therefore needs to find through diet or supplement. There are many food sources but you can buy a supplement in most countries called L-Tryptophan.

Tryptophan is thought to be useful as a treatment of anxiety and depression (and other mood disorders) because it is a precursor to Seratonin. Your body uses Tryptophan to make Seratonin which is one of the most important neurotransmitters effecting mood. It also makes Melatonin, which helps control sleep.

Common dietary sources are things such as egg, cod, soya and some cheeses and some meats. Turkey is always said to be high in Tryptophan, but actually cod has more per kg. While many people get enough through their diet others do not. It is hard for Tryptophan to cross the blood-brain barrier because it has to compete with other amino acids. The best way round this is to eat some carbohydrate with the Tryptophan, which will release insulin which helps Tryptophan’s passage into the area of the brain where it is needed.

It is hard to say if Tryptophan works as an anxiety cure or a depression cure. Certainly many people find that carbohydrates make them relaxed which is likely due to elevated Seratonin levels in the brain. If that strikes accord with you then maybe supplementing is worth a try.

In may be better to supplement with Tryptophan than with its nearest neighbour 5-HTP, which has a habit of converting to Seratonin outside the brain and is thought to cause heart valve damage. The only real way to know if Tryptophan works for anxiety is to try it!

5 – HTP Anxiety Remedy?

5 HTP has been touted as a cure for various Serotonin deiciency related illnesses such as Anxiety, Panic Attacks, weight los, insomnia, and depression. 5 HTP, or 5 hydroxytryptophan to give it it’s full name, is manufactured from an African Plant called Griffonia simplicifolia, it is not really practical to get enough of this in your natural diet, so concentrated supplement form is the only way forward. It is commonly found in Healthfood shops and is not normally classed as a drug. Relying on drugs and supplements might not be wise.

Dosage of 5 HTP. When it comes to supplements slack regulations allow manufacturers to be vague. For anxiety, depression, panic attacks and agoraphobia normally 50-100 mg are recommended three times a day. This can be adjusted depending on success and tolerance. For insomnia a single dose half an hour before bed is recommended, again of approximately 50-100 mg. For weight control the same dosage is suggested twenty to thirty minutes before eating. To avoid side effects it is better to start on a low dose and gradually increase.

Dangers: 5-HTP is pretty safe ***but*** there is some evidence that 5-htp can cause damage to heart valves over time…I can find no definitive scientific answer to this question, so maybe more research is needed.  It is not associated with the same number of severity of side effects as traditional medical antidepressants such as Prozac, Celexa, and the other SSRIs. There was a rumpus in the past about a contaminated batch of l-tryptophan in the USA which caused serious illness and death. This was not due to the supplement but to the contamination of one brand in one factory.

Side effects: nausea, constipation, gas, drowsiness, or a decreased sex drive. These are usually mild if present at all, and pass quickly. Generally 5-htp’s side effects are considered to be much less than SSRIs. Check this post on 5-HTP side effects as well.

Length of time
Generally it can take 2-4 weeks for 5 htp to start working, or achieve clinical effectiveness

Efficacy of 5 HTP
Definitely some clinical trials have found that 5-htp is for some people more effective than SSRIs. As ever the results of all the studies are hard to interpret and be sure about as researchers are oftened skewed. Pharmacology is a dirty business.

Warnings etc
Speak to your doctor! 5 HTP can react badly with SSRIs, MOAIs, some over the counter medications and may not be suitable for everyone. Speak to your doctor! (worth saying twice!)

In my opinion, 5 HTP can do good things for the anxiety, panic attack, and agoraphobia sufferer. It may be possible to get the same effect by increasing tryptophan rich foods into your diet! More about that tomorrow!