Dear kipsy,
Thanks for writing. Mental health professionals need support and consultation, too! One question I have before I begin: is there a reason you are seeking medication management from a physician that is not a psychiatrist? If you could, I would recommend having a psychiatric consultation and follow-ups. I would agree staying on medications is indicated. Two symptoms of perimenopausal women are depression and weight gain. As we get older, we have to work harder to manage our weight. Eating cleaner and exercising consistently to name a few. Loss weight on Wellbutrin could have kicked in your obsessive thinking about your weight, body image and eating. Cognitive behavioral therapy, dialectical behavior therapy and interpersonal therapy can help you work through some of these obsessive thoughts. Lexapro or zoloft as an antidepressant could be explored. Of course prozac at high doses (60-80mg) has proven to be effective for bulimia and binge eating. However, in 1/3 of the cases it causes weight gain. Using a low dose of abilify (2-5mg) to augment your antidepressant could support decreasing obsessive thoughts and suicidal ideation. You could consider this first before changing your anti-depressant. You also might want to research topomax as a medication to help curb the desire to binge. I hope your find this input helpful.
For more information on eating disorders, visit the bella vita website.
Best,
Dr Patricia Pitts
The Bella Vita
Los Angeles, CA
Thank you very much for the advice!! To answer your questions to me, I would like to be followed by a psychiatrist but ours are so busy (our wait list is upwards of 4 months) although I have thought of trying to consult with one of them (also I am a bit nervous going to docs I work along side) . In the mean time your advice is very much appreciated!!
Can I ask another question??? if I was to add the low dose prozac as you have suggested would you advise staying on the 300 mg of wellbutrin for a bit then maybe reducing it if I felt OK?? (and as summer is approaching hopefully better mood).
thanks for your help!!!
KIPSY