Tuesday, August 29, 2017

Follow-up on Medication

After taking phentermine for a month, I stopped because I ran out before I had a doctor visit. I had difficulty falling asleep on this stimulant.

At my doctor visit, I asked about other ideas. We thought of the generics of Contrave, which are buproprion (Wellbutrin) and naltrexone. Wellbutrin costs less, but not the naltrexone. It cost more than $100 for a month's worth. He prescribed Metformin to control blood sugar, and Wellbutrin as an experiment.

Ultimately, I tried Wellbutrin and Metformin. I stopped taking the Metformin because of the bowel symptoms. I stayed on Wellbutrin for 2 months with few results. I fluctuate within the same weight range since giving birth last year. I never returned to my PCP because the only medications left cost the weight of an arm and a leg.

I lost 2-4 lbs. when I went to sleep before 10:30 for a week. Going to bed on time, had a greater effect than anything else I have tried.

So what should be my goal? Go to sleep by midnight every night!

I bought a Fitbit the end of June. Now I have more information. I realize that I eat the same amount of calories as I burn most days. I usually hit 8000-10,000 steps a day and have active minutes from doing housework.

Since coming off the Wellbutrin, my appetite may have increased--due to stress. I have binged on several times when I felt bored or stressed. I gained 6 lbs back during my trip to see the eclipse and family.

My new fresh-out-of-residency psychiatrist said that Wellbutrin alone won't have much effect on weight loss. We discussed changing my mood stabilizer to topiramate and my antidepressant to buproprion, which are both ingredients in weight loss medications. My previous psychiatrist discouraged topiramate since brain fog is a symptom. My current psychiatrist said that symptom only occurred in some people. The "brain fog" at a lesser degree clears racing thoughts.

I am thinking of changing my psychiatric medications now. My mood stabilizer has worked for 11 years, and my current antidepressant has worked for 5 years. Neither of them cause weight gain. Changing medications takes several months. Those medications aren't guaranteed to work for my bipolar 2.

For now, I need to focus on going to bed earlier (barring my baby waking at all hours in the night), eating less and reducing stress.

Weight loss is such a puzzle.

Update:

I started the topiramate.