Which MAV anti-depressant has least side effects?

I’ve had a bad week, and it came after a pretty good couple of months. I was getting better, and the doctor was saying that he thought my condition was VN and not MAV since it seemed like I was retraining my brain to compensate, and it was learning a little bit more each month. I was able to work a full day and exercise and play with my girls at night. Well, I am back to where I was a few months ago, all that progress wiped out. I woke up two days ago in a half-spin, not as intense as my original room-spinning vertigo, but still very scary. I have not had an episode like that for many months; I thought it was all behind me. I am getting angry and desperate. I am now ready to just assume I have MAV along with whatever else I have (BPPV, VN, LABS). What anti-depressant would you recommend under the following conditions for a man in his late 40s:

–No weight gain (I am pretty thin and work hard to stay that way, don’t want to gain more than 5 lbs)
–No hair falling out (I am late 40s with a full head of hair, and I love it, don’t want to lose it like other guys)
–No sexual disfunction (I am already not performing like I did at 18 or 25 yrs old, why make matters even worse)

There you have it. Please help me.

It’s hard to answer this question since drugs will have different effects for different people.

I’ve had different experiences with the two different ones I’ve tried. Prozac so far has had none of the side effects that Celexa did. I gained 30 pounds on Celexa, but I was on it for 14 months, while I’ve only been on Prozac for ~3 months so I could still see some weight gain. No sexual side effects on Prozac while I did have that with Celexa. I felt numb/flat on Celexa while Prozc is more ‘stimulating’, as they say.

Can you try another med like propranolol or topamax before trying an AD? Sounds like you need something to help kick this stuff, sorry you are struggling! But there are a lot of different things you could try until you find the med(s) for you.

Hi LS,

There really is no answer for this. Everyone will react differently to them all. However, there is data showing which ADs have the lowest side effects overall in large clinical trials. Zoloft from my recollection comes up as one of the better ones. Having said that, Zoloft was the worst AD I ever tried. So there you go – there is no clear cut answer.

Wellbutrin is generally thought to be lower in SEs than the others in terms of sexual side effects and weight gain but not much good for migraine.

Best … Scott

I’ve been great with Lexapro. Minimal weight gain- 10 pounds? And I hear ya about the sex thing, I have a low libido normally so not sure if it’s made it any worse or not… I’d say Lexapro has been fairly mild!

— Begin quote from “Anne”

It’s hard to answer this question since drugs will have different effects for different people.

I’ve had different experiences with the two different ones I’ve tried. Prozac so far has had none of the side effects that Celexa did. I gained 30 pounds on Celexa, but I was on it for 14 months, while I’ve only been on Prozac for ~3 months so I could still see some weight gain. No sexual side effects on Prozac while I did have that with Celexa. I felt numb/flat on Celexa while Prozc is more ‘stimulating’, as they say.

Can you try another med like propranolol or topamax before trying an AD? Sounds like you need something to help kick this stuff, sorry you are struggling! But there are a lot of different things you could try until you find the med(s) for you.

— End quote

OP here. I tried Topomax for a few days, it gave me two weird side effects. The first was eye pressure; the week before starting on the Topomax I had just undergone an eye exam at Lens Crafters, so when my eye began to hurt on Topomax I went back and had them put me in the eye pressure machine that tests for glaucoma, and the pressure had risen from a score of 16 to a score of 22 in one week. I found that odd. Then I was driving home from work one day and starting thinking to myself, "What if there is a robber at my house, I would have to get a knife from the cutlery holder and start attacking him and cutting him up etc etc; suffice it to say that I never have thoughts like that. So I stopped. As for the ADs, I have avoided them out of vanity, truth be told.

Do you need to start with an anti-depressant for some reason? Drugs like verapamil, topamax (often weight loss), and neurontin (often weight neutral), might be better suited to fit your needs initially. Plus, if your trial does not work there is less of a discontinuation syndrome in tapering off them.

Effexor is not bad with regards to weight, and most studies point to zoloft as being weight neutral.

Good luck!
lisa

— Begin quote from “MAVNY”

Do you need to start with an anti-depressant for some reason? Drugs like verapamil, topamax (often weight loss), and neurontin (often weight neutral), might be better suited to fit your needs initially. Plus, if your trial does not work there is less of a discontinuation syndrome in tapering off them.

Effexor is not bad with regards to weight, and most studies point to zoloft as being weight neutral.

Good luck!
lisa

— End quote

I want to try an AD because I am starting to think that this condition is probably MAV. MAV has always been in the background, but I was diagnosed with BPPV, then with VN, not with MAV. I was pretty sure I had VN for which I was getting better at compensating, but the fact that it gets better then worse then better then worse, seems to contradict the diagnosis of VN where the brain should get increasingly better at compensating.

I already take Atenolol for migraine prevention, so I cannot take another drug in the same class. I tried Topamax and didn’t like it. I will look into Zoloft. Thanks.