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Ask Selah R, M.S. LPC Your Own Question
Selah R, M.S. LPC
Selah R, M.S. LPC, Therapist
Category: Mental Health
Satisfied Customers: 582
Experience:  Licensed Professional Counselor; over 13+ yrs exp working with adults, teens, & families/couples.
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Which antidepressant won't affect sexuality, weight gain or

This answer was rated:

which antidepressant won't affect sexuality, weight gain or cause insomnia? i have been on lexapro and now effexor and need to take sleeping pills to sleep every night and have put on weight which dpresses me.
Selah R, M.S. LPC :

Thank you for trusting JustAnswer with your important question.

Selah R, M.S. LPC :

Unfortunately, each medication can effect people in different ways, and most antidepressants commonly affect sex drive. The two that have the least side effects in that area are Lexapro and Wellbutrin.

Customer:

I've read that Wellbutrin can cause insomnia and I alraedy suffer from this?

Selah R, M.S. LPC :

Both of those also tend to have less weight gain reported. But they work in slightly different ways in the body, so one may work much better for you than the other. Some people feel overly energized with Wellbutrin though.

Selah R, M.S. LPC :

Zoloft and Paxil are also ones worth looking at based on the research. They aren't as side-effect free sexually and weight-wise as the other two, but are still better than most antidepressants.

Customer:

Feeing more energetic would be good as I have been quite lethargic and get up at 11, but I need help to sleep. What do you think?

Selah R, M.S. LPC :

There is also a new patch called EmSam that works like an MAOI without the dietary restrictions. It requires a much lower dose because it is absorbed by the skin, so it has so far shown fewer side effects than others in that class.

Selah R, M.S. LPC :

When you took Wellbutrin, did you take it in the mornings? Did it make the insomnia worse?

Customer:

what are the side effects for em sam? i haven't tried wellbrutin

Customer:

????

Selah R, M.S. LPC :

Wellbutrin might be worth trying then, as it is more closely related chemically to the Effexor and Lexapro compared to the EmSam.

Customer:

but will it affect my insomnia?

Selah R, M.S. LPC :

EmSam has many of the same side effects as traditional antidepressants, but a higher risk of high blood pressure problems in the moderate to higher doses.

Selah R, M.S. LPC :

Tell me more about your insomnia and what you think causes it.

Selah R, M.S. LPC :

Insomnia is difficult because anxiety can cause it, and some antidepressants can help anxiety and therefore help the insomnia. Other insomnia is more of a sleep cycle disturbance, and medications like Rozerem can help re-regulate that.

Selah R, M.S. LPC :

What are you currently taking for sleep?

Customer:

not sure if the effexor is causing it. Usually cant sleep till about 2am after taking a pill and then ok sleep till 11 or so.

Selah R, M.S. LPC :

What happens when you try taking the Effexor in the morning instead of the evening?

Customer:

stillnox cr

Customer:

it would make me sleepy and tired and then awake at night

Selah R, M.S. LPC :

So if you take it in the morning it makes you sleepy, but if you take it at night it keeps you awake?

Customer:

no if i take it too early it doesnt work

Selah R, M.S. LPC :

Are you on Effexor, or Effexor XR?

Customer:

so i need to take an extra one sometimes

Customer:

effexor xr

Customer:

225mg

Selah R, M.S. LPC :

Your body may be processing the Effexor XR too quickly, so that it's not staying in your body as long or as evenly as it should.

Selah R, M.S. LPC :

What do you think causes your insomnia? The body isn't tired, the brain is too active, anxiety kicks in?

Customer:

brain too active

Selah R, M.S. LPC :

And your diagnosis is depression? Bipolar?

Customer:

depression- mood disorder with anxiety

Selah R, M.S. LPC :

You might want to talk to your doctor about Wellbutrin then. Adding it to Effexor may help decrease the anxiety, which may help your body be willing to go to sleep easier.

Selah R, M.S. LPC :

Some doctors prefer to use Wellbutrin plus a traditional SSRI (like Lexapro or Zoloft), so they can more easily adjust the different medications to give you the best symptom managment.

Customer:

2 different medications at the sanme time would work?

Selah R, M.S. LPC :

Effexor is difficult because it acts mostly as an SSRI (like Lexapro) but at higher levels it begins to act somewhat like a weak SNRI (like Wellbutrin).

Selah R, M.S. LPC :

Yes, it's actually fairly common. SNRI's tend to work better for giving energy and managing anxiety. SSRI's tend to work better for depression.

Customer:

and what is wallbutrin classified at/

Selah R, M.S. LPC :

SNRI antidepressant

Customer:

how does that work differently to ssri's>?

Selah R, M.S. LPC :

They are targeting different neurotransmitters in the brain: one serotonin and the other norepinephrine.

Customer:

ill discuss with my gp pr should i see a pychiatrist for the best advice?

Selah R, M.S. LPC :

If your GP tried the Lexapro and now the Effexor, and you haven't been really happy with either, then it's probably time to see a psychiatrist who can best fit the medications to meet your specific symptoms.

Selah R, M.S. LPC :

They are going to have much more training and clinical experience with the different medications to know what has a better chance of working to meet your needs.

Customer:

yes that's what i was thinking. thans so much for your help

Selah R, M.S. LPC and other Mental Health Specialists are ready to help you