Darn! Zoloft seems like failure for difficult child. Weight loss and maybe other side effects

[SuZir]

I had my weekly Sunday call with difficult child and he told their trainer threw a fit after weighing difficult child. He has lost ten pounds in last four or five weeks. Zoloft gave him nausea for a week but while that has been better he seems to have lost his appetite. And first part of these four weeks he was on vacation and the last two weeks have not been that hard training either so he certainly shouldn't had been loosing weight but gaining a bit. Also body fat per cent is now far under the target range.

Otherwise side effects have not been too bad. Excessive sweating (that could be a real problem during the season though) and things like that. And of course we can't know if part of difficult child being a pissy brat is because of Zoloft and not because of the circumstances. Though he didn't seem too irritable after starting Zoloft before he got some bad news.

However there has been some positive effects too. Sleep (again) being a major one and even difficult child admits that. difficult child's self evaluated anxiety index is also down, but who knows how much is a medication and how much is other things. His insufferableness index evaluated by others is sky high, but it is likely because of attitude and not because of anxiety this time. And some anxiety is likely circumstantial, after all, he doesn't know when and where he will be moving, but knows he will and soon (and likely with short notice.) That is taxing to anyone.

He has an appointment with team MD tomorrow and he will likely consult difficult child's psychiatrist to decide what to do with medications. However difficult child considers weight loss to be intolerable side effect so I don't think continuing with Zoloft and seeing if it gets better is an option. I kind of disagree but I do understand also difficult child's point of view. That weight loss has been huge and so quick he is loosing a lot of muscle (not that he has much anything else to loose, his body fat percent was under 10 even before the weight loss now it closer to numbers suitable to ski jumpers than someone in difficult child's sport) and rebuilding it will take a lot of time and work and set him back a lot. He is in age there he really should be building foundations of his physique for rest of his career. A person can (without doping) gain only about five pounds of dry muscle a year. And that is with concentrating solely to building muscle which is not something difficult child could ever do in his training. So loosing muscles is unacceptable for him. Other options are of course quitting SSRIs totally or switching to something else. Luckily difficult child is not totally against switching. We will see.

Of course he could try simply forcing himself to eat, but he claims he has been doing that already and still keeps loosing weight. And anyway, if there will be a switch, it better be sooner than later. Any new medication, if not absolutely, 100 % essential will not be something difficult child is willing to test after early August. His biggest stipulation for agreeing to test SSRIs is, that when September comes, he is either stable on SSRI or not on SSRI. That kind of time limit hoovers, but I do understand difficult child's point of view also in that. And his life, his choices.

 

[HaoZi]

A person can (without doping) gain only about five pounds of dry muscle a year.

What is "dry muscle"? I've never heard this phrase. I have known many body builders who didn't dope that managed to put on plenty of muscle in far less than a year by eating lots of protein and training hard, though.

I'm sorry to hear that this medication isn't helping him as much as expected, though it does take about six weeks to get to a therapeutic dose in the system (I've been on it myself). Often with Zoloft weight gain is more of a problem than weight loss, too.

 

[SuZir]

What is "dry muscle"? I've never heard this phrase. I have known many body builders who didn't dope that managed to put on plenty of muscle in far less than a year by eating lots of protein and training hard, though.

Dry muscle is actual muscle tissue. Often when thinking muscle gain, you think of what is actual lean body mass but muscles are masters of preserving liquid and when someone for example gains 20 pounds and their body fat pre cent stays same (and they have not grown taller) they have actually gained that 20 pounds of lean body mass and most of it is water. Only about 25 % of that is actual muscle tissue, dry muscle. And to get to that you really have to concentrate on building muscle and you most likely have to eat more than you need and gain some fat along the muscle. For example body builders etc. usually have what is called 'mass building season' when they eat a lot more than they need, train hard, their weight goes quickly up (both muscle and fat) and after they have bulked up and before competitions or beach season they diet harshly to burn that fat and to get muscles to be seen. difficult child is not a bodybuilder but does sport there he needs a lot of quickness and agility, so he certainly can't bulk it up to get muscles. For him building muscle is very slow process and loosing even a pound or two dry muscle (of course not all that lost 10 pounds is dry muscle, most is water, some fat, but he has likely lost that pound or little more) can be a year of work in that department.

And yeah, I do know more often SSRIs tend to be weight gainers, but it just figures that difficult child, who could use a little weight gain is one of those who has a reverse side effect.

What I got out from difficult child (like pulling a tooth again ) it sounds like at least he himself is pleasantly surprised on how much Zoloft did actually help. It certainly didn't make all rosy, but difficult child is under heavy stress right now, so that could not be expected. If it helped with both sleep and anxiety this quickly, it is huge, I think. And even if he thinks side effects are intolerable, it gives me some hope, that maybe some other SSRI could also be helpful with lesser, or more tolerable to him, side effects. I think he at least has a little bit more positive attitude to SSRIs now. (He really, really hated it that he was forced to try.)

 

[HaoZi]

What I can say about my experience with Zoloft is that it was subtle - by which I mean I didn't notice effects right away or anything. It was such a slow effect that I just kind of noticed one day weeks later that I felt emotionally better, and had been feeling a little better every day and just hadn't really noticed at the time.
I can't say that's everyone's experience with it that it works for, but that was my experience with it, and it did work for me (and yes, over time I did gain weight on it, but not right away, not even in the first few weeks).

 

[nerfherder]

For what it's worth, I did have that effect with Z. Dropping the dosage then gradually building it back up over the course of a couple months made the appetite problem resolve. (I was overweight at the time, nothing to do with the Z or SSRI's, I was just an Eater of Starch.)

And the appetite problem wasn't simply "I'm not hungry" it was an actual "Food seems like a really stupid thing to do right now" revulsion of the idea of eating. So if that's what he's feeling, I remember that, and forcing myself to eat was extremely unpleasant.

 

[SuZir]

I know SSRIs tend to show their true colours both in good and bad slowly. And four weeks is a short time with them. For difficult child there has clearly already been some positive effects, but lack of appetite doesn't seem to be going away (and I think it is like Nerf described and really makes it difficult for him to eat enough) and difficult child doesn't seem to be ready to take a risk he looses more weight. I have to say that I would hope that he would be ready to try to tweak a dose and wait and see if it gets better, but I'm not the one who has lost all gain of countless hours at gym from the last year and who will be redoing it to get there he was just a month ago.

I would also wish that he would be little bit more patient with trials of these medications. That August will come awfully quickly when you consider the times one has to test one medication before you know if it works or not and are side effects going away or not. But I'm also ambivalent with that. Because it is a boundary he has drawn after listening experts and making compromise. It may not be a boundary I'm thrilled of, but I'm thrilled that he is drawing boundaries. I mean, I'm sure he expressed it to his psychiatrist with something like: "Okay, I will try these if you say I have to, but at least I will not try anything new after August and mess my season." And lots of pouting, but even if the way to express it may have been immature (at least how he told me about it, was), it still is proactive boundary he has drawn after listening advice and making decision about his own medical care from his point of view. And that is almost bigger than any medication.

He did meet a team MD today, but I don't know what he said or what was decided. When I called difficult child to ask, he didn't have time to talk with me, he was playing golf.

 

[SuZir]

Okay, kid at least had decency to call back after being back from golf course. Sorry, I'm having difficulty getting over that one. It is somehow so very amusing and telling that I'm home fretting over my kid's mental health issues and the whelp himself is golfing in some country club and enjoying the first warmer and sunny days of the year. Not that there is anything wrong with golfing, or him doing so and especially when he was doing so with his former coach who is great mentor figure to him and important resource in his current professional situation. And it is also very descriptive on how complex his situation is. Both sides of him are true, one with serious mental health issues and challenges and the one on the golf course having good time.

But back to the topic. Team MD wanted difficult child to actually meet psychiatrist for the medication change. difficult child is not willing to continue Zoloft and neither is team MD fond of him continuing. He did consult psychiatrist briefly and difficult child's is starting to wean it down. psychiatrist was able to squeeze him in later this week and difficult child will likely start something else. Earlier she said she doesn't like prescribing Paxil for younger men because they too often find it intolerable so it will likely be something else even if paroxetime is aside of sertraline only one official accepted for PTSD.

 

[SuZir]

psychiatrist is switching difficult child from Zoloft to Lexapro. Today he called about something different and complained that he is terrible nauseous and threw up at the morning. He also has a headache. Only second day with Lexapro so at least side effects came quickly, or he got a stomach flu. If it's side effects, hopefully it goes away sooner rather than later. He is decreasing Zoloft and increasing Lexapro at the same time so that can be a problem too.

 

[welcometowitsend]

SuZir - He sounds like he is showing a lot of maturity with the decision making around the SSRIs. I'm glad that the Zoloft helped in some ways and he could see the benefit of continuing to take SSRIs.

I sure hope that he has a stomach bug and that the Lexapro works for him. Crossing my fingers.

 

[SuZir]

I sure hope that he has a stomach bug and that the Lexapro works for him. Crossing my fingers.

I too hope it is either stomach bug or short term side effect that wears out quickly. Or even hangover, I mean 19-year-old difficult child with nausea and headache at the morning after a night many have been out and about (we had a public Holiday today, Ascension Day and a popular sport event at Wednesday night so many were watching that in bars and continued from there, especially because it was really warm and nice evening for this time of the year and most bars have just opened their outdoor serving etc.) I may be naive because that didn't even come to my mind when he called, only much later. Of course he tends to be aware enough not to complain nausea and headache to me if it is due the hangover, especially as a medication side effect.

 

[SuZir]

Lexapro seems to be better fit for him side effects wise. Apparently he wasn't hangover or if he was, it was one mighty long one. Almost a week he started his mornings by puking (and I do think it is unlikely he would be preggers ) but eating helped with nausea and now that he is off Zoloft he is slowly getting his appetite back. Headache only lasted three days and now he says he doesn't have much side effects. Bit dry mouth and still sweating quite a lot, but nothing too bad. He lost a pound or two more but now that seems to be turning back to right direction.

if Lexapro will be of any help, that remains to be seen, but at least there are no intolerable side effects.