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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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I have been on Wellbutrin for depression (150 XL) once daily

Resolved Question:

I have been on Wellbutrin for depression (150 XL) once daily since a nervous breakdown over 11 years ago....was seeing a psychologist then who also put Me on Seroquel to be able to sleep & now am taking 400 mgs of Seroquel at night to sleep....I have gained over 50 pounds in the last 11 years & feel horrible...insomnia still is a problem unless the Seroquel is taken...I need to lose weight & am feeling more depressed because of it...Some mornings I wake up feeling very depressed even with the Wellbutrin...is there any other sleeping prescription I can suggest to My Family physician to prescribe for Me so I can wein off of Seroquel and because I have no health insurance coverage I can not go to a Psychologist to see what else I can use that is stronger for Depression. Does the Seroquel & Wellbutrin make You gain weight or is it just that I am in My late 50's that My metabolism sucks....I tried the atkins diet once again & lost 2 pounds in 3 months which is not what atkins says...I should have lost alot more in 3 months than 2 pounds...My Family Dr charges Me $200 a visit...
Submitted: 1 year ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 1 year ago.

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Dear friend,

Elliott, LPCC, NCC :

I believe that I can help.

Elliott, LPCC, NCC :

You are getting very expensive healthcare and have only a GP giving you mental health treatment.

Elliott, LPCC, NCC :

Seroquel is probably responsible for a lot of the weight gain, and it is probably more pronounced because of your changing metabolism.

Elliott, LPCC, NCC :

Wellbutrin is known to be one of the few antidepressants that does NOT promote weight gain.

Elliott, LPCC, NCC :

You are only on a starting dose of Wellbutrin XL.

Elliott, LPCC, NCC :

The usual adult target dose is 300 mg/day, given once daily in the morning. Dosing with WELLBUTRIN XL Tablets should begin at 150 mg/day given as a single daily dose in the morning.

Elliott, LPCC, NCC :

If that dose is well tolerated then it can be increased to 300 mg. per day.

Elliott, LPCC, NCC :

An increase to the maximum of 450 mg/day, given as a single dose, may be considered for patients in whom no clinical improvement is shown after several weeks of treatment at 300 mg/day.

Elliott, LPCC, NCC :

Rather than taking Seroquel, you should asked to be VERY SLOWLY weaned from it.

Elliott, LPCC, NCC :

You might try melatonin, a supplement that you can get over the counter which can regulate your circadian rhythm and help you sleep.

Elliott, LPCC, NCC :

You should get off caffeine and use no artificial sweeteners.

Elliott, LPCC, NCC :

You would be better off getting help from a psychiatrist.

Elliott, LPCC, NCC :

Some of your problem might be anxiety which can be helped by the Wellbutrin.

Elliott, LPCC, NCC :

If you are getting some anxiety you can talk to your doctor about taking a low dose of the antianxiety medication clonazepam (Klonapin) at night because it helps with sleep. It should not be used for a long time or should be used only as needed because it can be habit forming.

Customer:

would it be okay to take 2 wellbutrin XL then if I arise feeling so depressed that I do not want to get out of bed?...My Family Dr told Me to start Ambien 5mg around 3 months ago & to keep cutting back on the Seroquel....I am down to 100mg to 150 mg of Seroquel at night along with the Ambien 5mg She prescribed...I have tried Melatonin years ago & it is not strong enough for Me...I had 2 parents pass away within a year 11 years ago which put Me in a severe state of depression & lead to a nervous breakdown....I have yet to get over it....anxiety is a definate in My life along with stress...

Elliott, LPCC, NCC :

Wellbutrin and other antidepressants act over time and are not something that you can raise or lower the dose on in order to strengthen or lessen the effect.

Customer:

Since I have cut back from 400 mgs of Seroquel to 100 to 150mgs at night I still havent lost a pound...I do not take caffeine but I do use Equal as a sugar substitute...do You recommend deleting the Equal as well?

Elliott, LPCC, NCC :

You are on a beginning dose of Wellbutrin and should probably be taking a larger dose.. It takes several weeks to kick in. You can't go up and down with the dose.

Customer:

Oh okay. So on My next visit to My Family Dr I will ask Her to increase My dose then...If I have cut back on the Seroquel why havent I begun to lose some weight do You think?

Elliott, LPCC, NCC :

Equal is not as harmful as aspartame but may be unsafe. The best sweetener is Stevia which is a natural product from the Stevia plant leaf and is not known to be harmful, and has virtually no calories.

Customer:

Okay I will try Stevia.

Elliott, LPCC, NCC :

It takes time, and your metabolism has slowed down. Losing weight is difficult. However, it is known that most antidepressants and many other psychotropic drugs, cause weight gain, and that Wellbutrin does not. It also does not have sexual side effects (libido loss) unlike other antidepressants which do.

Elliott, LPCC, NCC :

Stick to a modified Adkins diet with a minimum of whole grains, no sugar, and as organic and chemical free as possible, with plenty of green vegetables, particularly raw ones.

Customer:

I also was told that My thyroid was wrong...I tried taking Levothyroxin 112 mg 1 qd...it does nothing for me...My friend started the same medication & she has lost alot of weight...My family doctor had My thyroid tested & said I only need 112mg qd...my friend also said that when she doesnt take her thyroid medicine she feels horrible...the levothyroxine doesnt change anything with me....have been on thyroid medication for years because drs said that could also be why I am gaining weight...

Customer:

I think its a bunch of crap to be honest with You....I was told I was taking the levo wrong...to take it in the am with a full glass of water...that didnt change anything either....is having a bad thyroid a bunch of baloney?

Elliott, LPCC, NCC :

This is an important consideration. You should be seeing a specialist that deals in hormones and not letting a family practitioner act as this specialist and that specialist.

Customer:

I do not notice a difference wether i take the levo or not...what do you think?

Customer:

what kind of specialist do I seek for this?

Customer:

The family dr made me do blood work & said My thyroid was off & precribed the levo

Elliott, LPCC, NCC :

Endocrinologist. These are the ones who can stabilize your hormones and this may help your weight problems.

Customer:

can I ask You another question?

Elliott, LPCC, NCC :

He may be right, but since you do have problems with your thyroxin levels, you should see an endicrinologist.

Elliott, LPCC, NCC :

Yes. Ask away.

Customer:

years ago I saw an endocrinologist back in Jrz....that dr put me on dexidrine for it....he said I had idiopathic edema....I bloat up by the end of the day...I get puffy and bloated...feel lighter in the a.m....that was in Jrz....I moved to Florida 5 years ago & the drs here said the dexedrine is just a diet pill and they will not prescribe it...they just laughed about the Dr in Jrz saying I had idiopathic edema

Customer:

when I took the dexedrine I was at my normal weight of 120lbs....I am 5ft 3inches tall...I now weigh 170 pounds....50 pounds heavier...

Customer:

I still get puffy & swollen by the early afternoon near dinnertime...my pants get tighter by then too...& I barely eat any food...no appetite to be honest with You...I take protein shakes for breakfast every morning since i cant eat food...it makes me nauseous in the morning...I am luck to get a yogurt in at lunch time....my dinners consist of chicken....veggies...and then fruit...I eat akins bars at night to snack on....I try to drink at least 32 ounces of water daily.....no luck losing weight

Elliott, LPCC, NCC :

Idiopathic edema could be caused by depression, or trouble with your hypothalmus or diabetes.

Customer:

So You have heard of idiopathic edema then? They just laugh at me down here in Naples Fl...2 different family drs I have seen in the last 5 years

Elliott, LPCC, NCC :

If you have been diagnosed with this edema then you should definitely see an endocrinologist.

Customer:

they both said its a diet pill & will not prescribe it

Customer:

okay...I will seek an endocrinologist then down here....maybe then I will be understood and not laughed at

Elliott, LPCC, NCC :

It is used as a diet pill and it will increase your metabolism but will make you very nervous and may disturb your entire sense of well-=being.

Customer:

the family dr I see now actually printed up on paper about dexedrine and gave it to me and said its a diet pill then laughed

Customer:

oh....yes, it did keep me up alot ....you are right on the money on that

Elliott, LPCC, NCC :

It is a stimulant. An endocrinologist will probably give you something that will treat you instead of just speed you up.

Customer:

is there anything else that can increase your metabolism until I can afford to see the specialist since I am out of work or no?

Elliott, LPCC, NCC :

College students used to use it for staying up and studying, but it wrecks you and iif you take it you will never sleep.

Elliott, LPCC, NCC :

Exercise, exercise, and exercise including walks (on the beach because you live in Naples).

Elliott, LPCC, NCC :

If you want to talk to a good therapist in Naples, try Dr. Bill Westman. He is a very smart and caring man.

Customer:

I even tried a place down here in FL called the medi weightloss clinic....did that for a month...they said i would lose 5 to 10 pounds in the first week....I lost 2...it is exactly like the atkins diet so since they charged $80 a week to go to them I couldnt afford it & am continuing the atkins diet myself

Elliott, LPCC, NCC :

You don't need a clinic to eat low carbs and high protein.

Customer:

Yes, I am ashamed that I do not exercise....

Elliott, LPCC, NCC :

Start with a walk everyday. Go early before it gets hot.

Customer:

I am 59 yrs old...an old fart...hate to go to the gym alone here...& My development has a state of the art gym

Elliott, LPCC, NCC :

Increase it. The fresh air and the sun will do you a world of good.

Customer:

okay....then just walking...?...how far or how long?

Elliott, LPCC, NCC :

You are a young 59 and if you don't like a gym walk on the beach. I would take the beach anyday.

Customer:

is a tread mill the same or no?

Elliott, LPCC, NCC :

To your limit.

Elliott, LPCC, NCC :

A treadmill is boring and the beach is brand new every day at the water's edge. Be the first human to make tracks in the fresh sand.

Customer:

I am embarrassed to go to the gym during the day because I am so overweight...I also have bad knees...they are supposed to be operated on ....bone against bone rubbing but opted out of the surgeries for that

Customer:

You sound like a good therapist....

Elliott, LPCC, NCC :

Go to the beach and wear knee support pads to protect them.

Elliott, LPCC, NCC :

Thanks. I care and that helps.]

Customer:

oh okay...knee support pads...never thought of that

Customer:

thank you so much....you have been a great help....if I can get to see Dr. Westman should I tell Him You sent Me?

Elliott, LPCC, NCC :

Fresh air, sea gulls, the ocean mist. And swim if you are not afraid. (I'm not).

Customer:

Where are You located?

Customer:

You sound like a FLoridian!!

Elliott, LPCC, NCC :

Southern Kentucky. Have spent much time in Palm Beach and Dade Counties and my son lives in the panhandle.

Elliott, LPCC, NCC :

But I love Florida.

Customer:

Oh okay....so You have been to Florida...Kentucky huh?

Customer:

I heard the weather there in Kentucky is also nice

Elliott, LPCC, NCC :

Yes. I live in very rural area.

Elliott, LPCC, NCC :

It is nice sometimes but can be too hot or cold.

Customer:

Well thank you for your expert advice and help....it has been a pleasure...if I need to consult again can I ask for You?

Elliott, LPCC, NCC :

It got cool today but I still went for a swim at 62 degree air temperature (water much warmer).

Elliott, LPCC, NCC :

Please do. I will do my very best to help.

Customer:

Kentucky reminds Me of horses & I love horses

Elliott, LPCC, NCC :

And thank you so much for your kind words.

Elliott, LPCC, NCC :

Me too. I have two here. Red and Tom. LOL.

Customer:

okay...& shall I mention Your name if I get to see Dr Westman or no?

Customer:

Wow! 2 horses! Lucky!...do You ride? I bet You do

Elliott, LPCC, NCC :

Definitely. He is a very intelligent, ethical, and likeable man. He may not have a doctorate but he is a licensed LCSW.

Customer:

Well it has been a pleasure...glad I tried Just Answer out...okay...I will mention Your name then if I get to see him...just say Dr Elliott?

Elliott, LPCC, NCC :

www.williamwestmanlcsw.com

Elliott, LPCC, NCC :

From KY. That will clinch it.

Customer:

okay....thanx for the link

Elliott, LPCC, NCC :

I shall keep you in my prayers.

Elliott, LPCC, NCC :

Warm regards,

Elliott, LPCC, NCC :

Ellliott, MAE, LPCC, NCC, CCHMC

Customer:

okay I will...have a blessed evening and weekend...thank you...for Your prayers...You sound like a dear man

Customer:

I will rate You an excellent on here as well

Elliott, LPCC, NCC :

Thanks. You just made me laugh with joy.

Customer:

You are quite welcome...it helped alot speaking with You

Elliott, LPCC, NCC :

Great.

Customer:

Take Care....be blessed

Elliott, LPCC, NCC :

You too.

Customer:

bfn

Elliott, LPCC, NCC :

until we meet again

Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
Elliott, LPCC, NCC and 2 other Mental Health Specialists are ready to help you

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