Often, medications taken to treat a variety of ailments — from depression to diabetes to seizures — come with an unwelcome side effect: weight gain.
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But at a time when 40 percent of adults and almost 20 percent of children and adolescents in the U. Excess weight increases risk of heart disease and other illnesses. The good news is alternative drugs often are just as effective without causing weight gain. As with most things medical, treating an illness is often a matter of balancing the good with the bad.
These common drugs could be making you fat
So, as a rule of thumb, talk to your doctor about treatment options if, after starting a new drug, you find yourself gaining 8 to 10 percent of your initial body weight. It can, for example, make depression worse and more difficult to treat, or cause rebound seizures in those with that condition. Worldwide, depression is the No. And the Centers for Disease Control and Prevention estimates that 1 in 10 people older than 12 take medication for the condition. One common symptom of depression is loss of appetite. So when patients start taking antidepressants, including selective serotonin reuptake inhibitors such as paroxetine Paxil and fluvoxamine Luvox , their appetite often comes roaring back.
And with it, the pounds. Wilkening said that patients who are concerned should ask their doctor about alternatives medicines not associated with weight gain, including fluoxetine Prozac , citalopram Celexa , escitalopram Lexapro , sertraline Zoloft and bupropion Wellbutrin. A study in the journal Obesity found those who took antihistamines daily had larger waistlines and higher insulin levels, a sign of obesity.
Newer drugs, including cetirizine Zyrtec , fexofenadine Allegra and loratadine Claritin , are less likely to cause weight gain, according to Long. The mechanism by which the anti-seizure medicine divalproex Depakote causes weight gain is not well understood, although it may be because the drug, which is also prescribed to treat frequent migraine headaches and bipolar disorder, increases cravings for carbohydrates. In a study in the journal Seizure , for example, a quarter of men and almost half of women who took the drug for a year or more gained an average of 14 pounds.
If you need to go to hospital, take the lamotrigine packet or the leaflet inside it, plus any remaining medicine, with you. But if you develop a skin rash or redness, tell a doctor straight away, as this can develop into a life-threatening skin condition called Stevens-Johnson syndrome. Stevens-Johnson syndrome is a rare side effect of lamotrigine.
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It causes flu-like symptoms, followed by a red or purple rash that spreads and forms blisters. The affected skin eventually dies and peels off. It's more likely to happen in the first 8 weeks of starting lamotrigine, or when the dose is increased too quickly.
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It can also happen if lamotrigine is stopped suddenly for a few days and then restarted at the same dose as before, without reducing the dose and then increasing it slowly again. To help prevent the chance of you getting a rash that could be confused with Stevens-Johnson syndrome, it's best to not start any new medicines, foods or products during the first 3 months of treatment with lamotrigine.
It's also best to not start lamotrigine within 2 weeks of a viral infection, vaccination or rash caused by something else. These common side effects may happen in more than 1 in people. They're usually mild and go away by themselves. Keep taking the medicine, but talk to your doctor if these side effects bother you or do not go away:. In rare cases, it's possible to have a serious allergic reaction anaphylaxis to lamotrigine. These are not all the side effects of lamotrigine. For a full list, see the leaflet inside your medicines packet.
But for safety, your doctor will only advise you to take it in pregnancy if the benefits of the medicine outweigh the risks. If you become pregnant while taking lamotrigine, tell your doctor or nurse straight away. Do not stop taking it without talking to your doctor first. If you have epilepsy, it's very important that it's treated during pregnancy as seizures can harm you and your unborn baby.
These common drugs could be making you fat
If you're pregnant, or trying to get pregnant, and taking lamotrigine, you're recommended to take a higher dose of folic acid, a vitamin that helps your baby grow normally. Your doctor might prescribe a high dose of 5mg a day while you're trying to get pregnant and during the first 12 weeks of pregnancy.
If your doctor or health visitor says your baby is healthy, lamotrigine can be taken while you're breastfeeding. It's important to keep taking lamotrigine to keep you well. Do not stop taking it without talking to your doctor. Breastfeeding will also benefit both you and your baby. If you notice your baby is not feeding as well as usual, seems unusually sleepy, or you have any other concerns about them, talk to your pharmacist, health visitor or doctor as soon as possible. For more information about how lamotrigine can affect you and your baby during pregnancy, read this leaflet on the Best Use of Medicines in Pregnancy BUMPs website.
Some medicines and lamotrigine interfere with each other and increase the chances of side effects.
Your doctor may need to change your dose of lamotrigine. There might be a problem taking some herbal remedies and supplements alongside lamotrigine, especially ones that can cause rashes, sleepiness or shaking and tremors. Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements. For epilepsy — brain cells normally "talk" to each other using electrical signals and chemicals. Seizures can happen when the brain cells are not working properly or working faster than normal.
Lamotrigine slows down these electrical signals to stop seizures. For bipolar disorder — we do not really know how lamotrigine prevents low mood in people. It might work in a similar way to epilepsy. Sometimes it's called a mood stabiliser, as it reduces mood swings. It usually takes around 6 weeks for lamotrigine to work properly. This is because the dose needs to be increased slowly to prevent side effects. But there are some side effects that might happen over a long time.
Long-term treatment with lamotrigine can cause osteoporosis and osteopenia , increasing your risk of breaking a bone. If you're taking lamotrigine for bipolar disorder, it's usually safe to stop taking it without having to reduce your dose first. If you get a serious side effect, such as a severe skin rash, your doctor may tell you to stop taking lamotrigine straight away, even if you have epilepsy.
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If you're switching medicines, it's very important to do it exactly as your doctor tells you to. If you want to switch, you'll usually start taking the new one at a low dose and slowly build up the dose while you're still taking lamotrigine. Once you're taking the correct dose of the new medicine, you should be able to slowly reduce your dose of lamotrigine.
Lamotrigine can also cause some unpredictable side effects no matter what dose you take, and these can happen at any time. There are lots of medicines that can be used for epilepsy and bipolar disorder, but they work in different ways. If you have epilepsy, the choice will depend on the type of seizures that you have.
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Your doctor will discuss the best medicine for you. If you have low mood with bipolar disorder, other medicines your doctor might use include lithium or quetiapine. If your epilepsy has been hard to control in the past and the brand of lamotrigine you're now taking is working well for you, your doctor may recommend you stay on the same one. Talk to your doctor if you have been asked to switch to a different brand of lamotrigine and you're worried about it.
But sodium valproate can increase the amount of lamotrigine in your blood, so your doctor may prescribe a lower dose of lamotrigine. It varies from person to person, and depends on the type of seizures and how often you have them. Before prescribing a medicine, your doctor will also take into account your age and gender, the medicines you're already taking and any other health problems you may have.
It's usual to try to treat epilepsy using a single medicine. If this medicine is not working well or you're getting side effects, your doctor will generally try you on a different one. If a single medicine is not controlling your seizures, your doctor may recommend taking 2 or more epilepsy medicines at the same time.