craving for sweets,especially chocolate

[medhelpvolume]

Hi doc.I am 21 and i see a shrink and take luvox 50 mg,abilify 10 mg and valproic acid 300 mg(orfiril is called in my country to calm me down).Since i was a child(7-8 years old) i always had this craving for sweets,chocolate,coke,candy and if my mother wouldn't give it to me i would start to get very angry and extremly frustrated, scream and throw things.Back then i wasn't depressed and didn't take any medication.Now i still have cravings for chocolate especially after i take a nap in the afternoon i wake up agitated,nervous and must eat some chocolate .Or when i am depressed i must eat sweets.Should i suggest my shrink to prescribe something for adhd,because i heard it is related with cravings and also i have a hard time focusing at college and procrastinate a lot?on the other hand stimulants could make more agitated and nervous?
What do you think?

[Peter Forster]

It sounds as though you have a side effect known as akathisia. Very unpleasant indeed... not dangerous but very unpleasant.

I would talk to your doctor.

We often recommend a dose reduction... sometimes starting at tiny doses with folks who are very sensitive.

[medhelpvolume]

I have been taking Abilify for a week now,and since then i feel very nervous and agitated,i can not sit still.What should i do?

[Peter Forster]

Glad you don't have a problem with too much weight.

Many of the problems you describe relate to an apparent deficiency of norepinephrine activity... Looking over your medications I see that you are not taking any medicines that boost norepinephrine.

You may want to discuss with your doctor switching from Luvox to duloxetine (Cymbalta) or venlafaxine (Effexor) (which would add some norepinephrine activity to the serotonin activity of Luvox)... you could also add another medication like modafanil (Provigil) or bupropion (Wellbutrin).

The trouble with some of these options is that they might cause weight loss and appetite suppression.

But they could help with focus, motivation and energy.

[medhelpvolume]

Thanks for the comprehensive reply doc.I would like to point out that i am not at all fat,all my life i have been skinny so probably sweets cause anxiety and depression in some other way.I will cut sweets at least for six months,no problem.The problem is with depression,procrastination,emotional numbness,unable to focus,no motivation,lack of satisfaction from anything,extreme feelings of guilt.I hope meds will start to kick in because i can not take it anymore,it goes on for 8 years.

[Peter Forster]

Sweet cravings are extremely common among folks with depression.

Unfortunately, as you may know, sweets increase depression at least two different ways -

first, more sweet intake may lead to weight gain and being heavy is associated with increased depression, second, although sweets are pretty good at reducing anxiety, heavy sweet intake over time seems to lead to more depression, even aside from weight gain.

In fact, the best diet for depression is probably something not that far from the Atkins, very low carbohydrate diet.

When I talk to my patients about the Atkins I point out that it is true that the induction phase (especially the first four days) is a bit like the first few days of quitting smoking in terms of cravings, after that they can expect their sweet craving to almost magically disappear.

By contrast, I haven't found that medications are all that useful in preventing carbohydrate cravings - although if you are a bit depressed it definitely will help to do whatever works to get rid of that depression.

As for the tendency to procrastinate, it is pretty hard to force yourself to do things in a timely fashion if you feel that whatever you do will be unsuccessful (depression) so I would start with aggressively treating depression.

However, once you have done that, you may well find that now you have learned a new habit - putting things off - and you may need to break that bad habit. Cognitive-behavioral therapy is pretty helpful with procrastination and avoidance. Just make sure to reward yourself enough in the early stages of change - which are usually the hardest ones.

[Jaquta]

I procrastinate too but I think that is more about anxiety and the need to be perfect and not be judged.

Food can sometimes be a substitute for love or emotional gratification.
Food is something that doesn't reject or let people down.

Your mother by giving in wasn't setting very good limits and boundaries and wasn't helping you to learn to contain your intense emotions.

It could be due to low blood sugar levels or just feeling emotionally empty or uncontained.

My understanding is that there is a link between depression and cravings or increased food intake.  Probably has something to do with feel good hormones.
I haven't looked at most depression stuff for years and feel a bit stupid for not knowing, or not being able to recall, the answer.

I wouldn't be asking for any medication for cravings.
An inability to focus and a tendency to procrastinate may be due to things other than adhd.

I am amazed by the number of people with mh issues who have said that they procrastinate (and are disorganized).

I hope the doctor can help you.

[whitecat78]

I have the same problem often. Sometimes I will take a nap and wake up feeling very irritable and crave chocolate. I have a procrastination problem too. Not sure what this relates too.