Anafranil

[sarahlevin]

Is Anafranil still the most effective drug (for most people with OCD)? I'm willing to take the risk of trying it knowing a lot of people gain weight on it because my life i unmanageable now. I can't go on this way. It's just that weight gain in itself can cause its own problems, my health.  I was told that the weight gain wasn't as common as it is with Zyprexa. I googled the percentage of people who gained weight but couldn't find an answer. I did see that in a sample of about 20 the people who took Anafranil compared to the control group (placebo) gained weight by about 5 times. The studies I looked at didn't mention the average amount of weight gained. The doctor I talked to about it said “Maybe the people who gained weight had an obsession (compulsion) for eating burgers and fries.” I understand what he was getting at–that there are many variables at play. Anecdotally, it looks like people gain between 10 and 75 lbs in a year. I did read that some people lose weight. It seems that increased appetite is the reason. Is it metabolic too–meaning, even if I restricted my diet and exercised more than before the Anafranil, could the weight gain be offset? Are there other physiological reasons for the weight gain? Are there medications to offset it? I've heard Topomax works but there is the word findng problem that can come with it but I suppose that depends on the dosage. I understand that everyone is different. 

Thanks.

Sarah

[sarahlevin]

I forgot to mention that I was only referring to medication treatment for OCD. I will be doing ERP.

[Dr. Michael Jenike]

hi Sarah

weight gain can occur with Anafranil and it is probably due to a metabolic effect.  Paxil is probably the worst drug in terms of weight gain.  if you exercise and watch what you eat, weight gain will be minimized.  also, good that you are doing ERP as that is by far the most effective treatment for OCD.  topamax is a drug that can help a person lose weight gain from psychiatric medications.  the word finding problems don't occur usually at low dose.  i would recommend 50mg a day to see if it help you lose weight.  most people have no problems with topamax at this dose.  all best wishes,

Michael Jenike, MD

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