AboutBarbara Judge Expertise Outpatient pharmacy and general health. I have recently completed a Pharmceutical Care Certificate Program offered by Purdue University (Spring 1999 completion). I have personal experience dealing with terminally ill persons and their needs, as well as their families` needs. I graduated in 1984 from Pharmacy School and have been a Licensed Pharmacist since then. I have 18 years retail pharmacy experience. Prior to my pharmacy training I have 3 years hospital experience as a Nurse`s Aide.
Question QUESTION: I've been given Pexeva at 10mg/ to try as an alternative to prior SSRIs I've taken, all of which I've dropped due to weight gain. I have searched the internet and found nothing to suggest that Pexeva would not cause the same type of weight gain side-effect as Paxil.
I have "run the gamut" taking SSRI's which I know have caused metabolic/weight gain issues. My psychiatrist and I
agree on my need for an antidepressant but he tends to be in denial about the notion that most of them cause weight gain.
He suggests taking a 4-5 week course and reporting back to him. Question being, what would possibly make this variant
different from Paxil with regard to the prospect of weight gain - which I most definitely did experience on Paxil.
Thank you! I am pondering this vs. Wellbutrin and even, lowest-dose Ritalin to at least deal with motivation...
Waiting on this to try and figure it out before I embark on any potentially metabolism-changing new Rx needlessly.
Thank you very much for any insight,
Mike
ANSWER: Pexeva is not significantly different from Paxil in side effect profile. They are both paroxetine, in different salt forms. This means they have different inactive portions of the molecule which falls away when the drugs dissolves and is absorbed into your bloodstream.
Wellbutrin is not an SSRI and may be a good alternative for you to try if there is nothing in your medical history to suggest otherwise. Ritalin is not indicated for depression. It is also highly addictive and should not be prescribed when not necessary. I would not think Ritalin would be a good alternative to even discuss with your doctor. If you have exhausted the SSRI's I would talk with him/her about Wellbutrin and see if your psychiatrist feels that is appropriate for you.
Thanks
Barb Judge
---------- FOLLOW-UP ----------
QUESTION: Thanks so much for this. I am tending toward Wellbutrin also. The only major issue I've heard of there that concerned me ws potential hair-loss though i've also noted that users at lower dosages report this to be less of a factor. I was going to ask separately whether perhaps there are natural supps. or medications that could be taken in concert with WB to "offset" any poential for the hair issue.
(having very healthy hair, i would find that side effect...Well..depressing ; ) -
Ritalin was primarily a 'last resort' option that he simply wanted me to try for a short course to see if it improved my lack of motivation which..actually, at the low dose of 5mg i did find helpful in that respect though did not really address any underlying depression symptoms as you suggest...
Thanks for your thoughts!
Answer While there have been post-marketing reports of hair loss in patients taking Wellbutrin the actual incidence is less than 1 in every 1000 patients taking the drug. At this rate it can not be determined that Wellbutrin is the cause of the hair loss or if there was some other issue with the patient that was not identified by the reporting methods.
If you are still considering a temporary trial of Ritalin it should be noted that Ritalin should not be taken with Wellbutrin due to the potential for drug interactions. It may be used with Pexeva as long as your doctor continues to monitor your condition.
