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Doxepin and Weight Gain

Misfit Toy

Senior Member
Messages
4,178
Location
USA
Hello, like-minded soldiers-

I went to my rheumatologist yesterday and told him my issue with sleep...that I don't sleep. I know there are many posts on sleep going on right now, so excuse this new one.

He was not thrilled with me being on Ambien 5 mg. He doesn't like it...for some reason or doesn't like keeping people on it. Interesting since my new psychiatrist says it's not addictive. ??

Okay, he gave me a script for Doxepin/Sinequan. I was on this years ago and I gained weight, big time. I also was exhausted on it and I can't remember the dose.

He gave me 5 mg of it. I can open it and take half. Last night I took it with Ambien and I died. I mean, it was some amazing sleep. However, I have dreams on it...lots of the dreams, interestingly they are about food. Or, maybe it 's because I am scared of the weight gain that I dreamt of food.

I woke up starving on this stuff. This is my fear. WEIGHT GAIN.

Why does one gain weight on it? Is it because you want to eat more, or because it messes with the metabolism?

I hate to give something up that puts me to sleep and I have little pain today, BTW. However, I am groggy and exhausted.

These are the meds I have; Restoril, Tizanidine, Klonopin, Ativan, Benadryl, Ketamine and that's about it for sleep...except now also Doxepin.

I can not take Trazadone. I am sick as a dog on it. Elavil makes me manic.

I would like to try and rotate and take Doxepin but I am at a perfect weight. I do not want to gain weight. I am sick of these meds making us balloon up or go down in weight. On Topomax, I was so thin and had zero appetite. I was sick on that med after awhile.

Thoughts? I will try rotating. And, I am going to take minute amounts of the Doxepin to avoid weight gain and feeling so tired.
 

minkeygirl

But I Look So Good.
Messages
4,678
Location
Left Coast
I am ok with doxepin but when I take one lyrica I spend the entire next day eating anything that isn't nailed down. I had the same thing with Neurontin.

I read on a forum awhile back for Lyrica or one of the drugs that causes weight gain and many people said they did not change their eating habits and they still gained weight. So maybe both?

Have you tried halcion? It is by far my favorite sleep initiator. Has a short half life. I take it every 3rd night so I don't develop tolerance.
 

out2lunch

Senior Member
Messages
204
I currently alternate 1mg of doxepin with 5mg of Benadryl in addition to 5-HTP, melatonin, phosphatidyl serine, GABA, and L-theanine. I also do CPAP for sleep apnea because of a narrow airway (not overweight).

I'm very drug sensitive so I don't need much. But before the sleep apnea was diagnosed, I didn't sleep as well as I do now and needed much stronger stuff.

I was given Ambien and Lunesta and Restoril for YEARS before a very smart orthodontist I saw for TMJ disorder discovered my upper airway problem. Sure enough, sleep lab PSG testing proved I had moderate sleep apnea which was worsening my insomnia. I still need help for sleep, but my supplement combo with a teeny bit of antihistamine is now enough.

Any prescription drug for sleep, especially the benzos, non-benzos, and tricyclics like doxepin, will worsen untreated sleep apnea and make you feel more hungover and tired the next day. And the sleep apnea will increase the need for a higher drug dosage to override the insomnia.

Is your doctor certain you don't have a sleep disordered breathing problem?
 

JAH

Senior Member
Messages
497
Location
Northern California
Interesting post and discussion. I've been on doxepin longer than any other drug - 20 years. I take 50 mg a night. It hasn't caused me any weight gain. I've had more problems with losing weight than gaining weight over the last 15 years, because of chronic nausea. (I've also taken every drug mentioned in this thread, lyrica, ambien, halcyon, neurontin, topomax, lunesta, restoril, trazadone! I think elavil, but not sure. Haven't notice weight gain in any of them...)

J
 

Misfit Toy

Senior Member
Messages
4,178
Location
USA
@out2lunch -I have not had a sleep study. I have too much going on including having had a surgery, physical therapy which is three days a week and doc appts constantly. I also could NEVER wear a c-pap. I hate noise. My days are doc appts. That's it.

@minkeygirl -halcyon made me hallucinate big time.

@JAH -you are somewhat lucky to lose weight!

I'm just tired today. It could be because I don't sleep and last night I slept and my body just crashed and is relaxed...finally.
 

GypsyGirl

Senior Member
Messages
165
Location
North Carolina
I'm on a night cocktail prescribed for pain from muscle cramping/tightness and inability to fall/stay asleep. It's 20mg baclofen, 4 mg tizanadine, and 1mg clonazepam. (The first two are muscle relaxants.) It's worked better than the z drugs and antidepressants (I get all the weird side effects) for me. Though clonazepam may not work for you with your reaction to benzos.

The idea is that the muscle relaxants help with pain and make me sleepy, and clonazepam (with its long half life) helps me stay asleep. I've not had to up dosage on anything since first prescribed, and haven't noticed weight gain/loss.

Started supplementing with 1mg reishi capsules a few days ago (wanted to see if they'd help inflammation), and a side effect is deeper, dreamier sleep. No drugged feeling. I haven't taken it long enough to know if the effect lasts, but I'm very pleased by a PLEASANT side effect. :p Just in case that's worth mentioning.
 

Misfit Toy

Senior Member
Messages
4,178
Location
USA
@GypsyGirl -thank you. I'm on Klonopin which is clonazepam. Also, Tizanidine. This just shows how different we are. Puts me asleep but don't stay asleep.

Benzos work well for me. My docs don't want me on them.

Also, will PM you when I get the chance!
 

out2lunch

Senior Member
Messages
204
@out2lunch -I have not had a sleep study. I have too much going on including having had a surgery, physical therapy which is three days a week and doc appts constantly. I also could NEVER wear a c-pap. I hate noise.
We're in a different era for sleep medicine now. The CPAP I'm using is amazing!

When I first tried CPAP almost 10 years ago, I couldn't adjust to the mask, or the constant air flow, or the noise. Now… ain't nobody taking my Auto PAP away from me! That's how much better I feel when I use it.

The new masks are so light, you barely know they're on your face. And the constant stream of high pressure air into your nose is gone. The newer machines sense when you've stopped breathing, and deliver the higher pressure only to get you breathing again, and then dial back down to the low setting automatically (hence the name Auto PAP). That made all the difference in getting used to the machine.

And I hear you about noise. I'm the queen of light sleepers. Outside wind will wake me up, or just a car driving by. But the newer CPAP machines are incredibly quiet! I have an air filter running on the lowest setting while I sleep, which I've gotten used to like white noise, and it's louder than the CPAP. When I turn it off, I still can't hear my CPAP.

As for sleep studies… there are newer ones that you do at home, that are pretty accurate. I did one three years ago before trying CPAP again, to see if I still had an apnea problem after weaning myself off sleep drugs that made my apnea worse. It was a device like an overgrown wristwatch that you wore to bed, that measured changes in your pulse, oxygen saturation, and I believe BP. It's called the WatchPAT: http://www.itamar-medical.com/WatchPAT™/Medical_Professional

Your doctor can order this for you, and almost every insurance company pays for it, including Medicare. Given the difficulties you have with your sleep, you owe it to yourself to see if this is a problem.
 

out2lunch

Senior Member
Messages
204
Also, @out2lunch -how do you get 1 mg of doxepin? We only have capsules in a 5 mg dose as the smallest. Are they compounded?
Actually, no. Doxepin comes in a oral solution from generic manufacturers. The one I'm using now is made by TEVA USA. It's 10mg/mL.

I pour it into an small empty dropper bottle and dose out two drops into a shot glass of water. I measured out my drops when I got the prescription and 1mg is about 2 drops.

I can't imagine taking 5mg in a single dose. I wouldn't wake up for at least 24 hours! :sleep:

Actually, that reminds me. My doc ordered genetic testing for me from a lab called Genelex. They found several mutations that make it very difficult for my body to clear certain drugs. One of them is CYP2C19, which is how tricyclics like Elavil and Doxepin and benzos like Valium and Klonopin are metabolized.

Has your doctor ever done studies like this for you? It's possible that you have some gene mutations that are working against you with regards to your meds.
 

Misfit Toy

Senior Member
Messages
4,178
Location
USA
@out2lunch -I had that test a week ago. They swab the inside of your mouth. It's for psych meds. Gene test. I have to be in touch with my doc.

I am exhausted of taking care of my health. TBH, I don't think I can even do the sleep study now. I have PT three times a week, a therapist, usually a doc appt and no time for a life. I have very little fun. Plus, I have a toothache and see a dentist this next week on top of the PT and my other doc...orthopedic. This is crazy. I am not just a CFS/ME person...I have everything wrong with me.

I need a break. I am becoming miserable from all of these appts emails to docs, questions...it's all bullshit.

I just want a strong drink and I want to sit on a beach. I bet you that would make me better than any medicine at this point.
 

out2lunch

Senior Member
Messages
204
I need a break. I am becoming miserable from all of these appts emails to docs, questions...it's all bullshit.

I just want a strong drink and I want to sit on a beach. I bet you that would make me better than any medicine at this point.
I know what you're going through. I was like that 20 years ago when I was forced to quit my job. I had active Lyme disease that was undiagnosed. I couldn't sleep, the pain was unbearable, and trying to do even the smallest amount of housework like cooking for 10 min was nearly impossible.

But some answer were finally found, like my broken methylation and the active Lyme disease, and I got most of my life back. Not enough to return to work, unfortunately. But at least I'm no longer bedridden.

Best of luck to you! Take care. :hug:
 

Misfit Toy

Senior Member
Messages
4,178
Location
USA
@out2lunch-thank you. I am glad you have gotten your life back! That is so great.

I am not bedbound, thank God and I get out everyday. I think things will be better once PT stops. I can't wait for it to end and maybe I should just call it a day. I have been in PT for 6 months for a broken wrist, etc. I am over it.

I have just had 3 diagnoses in the last two years that are wearing me out more than CFS ever did.

I was active with CFS. Very active. With the Sjogrens and the CVID, that's a whole different ball game. But.. I am working on it.

Again, thank you!
 

GypsyGirl

Senior Member
Messages
165
Location
North Carolina
@GypsyGirl -thank you. I'm on Klonopin which is clonazepam. Also, Tizanidine. This just shows how different we are. Puts me asleep but don't stay asleep.

Benzos work well for me. My docs don't want me on them.

Also, will PM you when I get the chance!

I've been lucky enough to have some docs be okay with the klonopin. (Probably since the dosage didn't change) Adding baclofen more might help... My initial doc was going by Dr. Charles Lapp's recommendation - that baclofen, tizanadine, and klonopin - they have a synergistic effect from what I understand. Using just tizanadine & klonopin didn't work until we added baclofen.

Looking forward to PM! But take your time; take care of yourself first. Many well wishes!
 

leokitten

Senior Member
Messages
1,542
Location
U.S.
Last edited:

Misfit Toy

Senior Member
Messages
4,178
Location
USA
Update-will not be able to take doxepin. Yesterday I ate more than I ever eat. It was nuts. Last night, I felt bloated.

I took a dusting of doxepin at bedtime. I died. Fell right to sleep.

Woke up and had diarrhea. Probably because I binged yesterday.

In bed. Exhausted. Was doing much better before this med. major setback.

Also, feel depressed. I feel flat.