I want to change my antidepressants

[Crematedashes]

Hi everyone. There is a TL;DR version at the bottom.

I'm currently on a very new antidepressant (so new that it doesn't have any generic versions yet). However, my psychiatrist gave me a card so that the copay is only $10 (as opposed to the $100+ it usually would be). It is also known to cause minimal side effects, and I have not reported any side effects to my psychiatrist as well as that it has helped. So money, side effects, and it being ineffective aren't going to be good excuses to switch my medication. Also, I have seen this psychiatrist for almost a decade - and he is the only psychiatrist I've ever seen.

Now onto the medication change. I am borderline overweight. I managed to lose about 5 pounds over the course of 9 months, but after that, my weight just won't budge. I'm also really short (won't mention my height) and as a result, my BMR (how much I burn simply for existing) is really low. And despite seeing a dietitian and following all her advice - eating only when I'm hungry, not eating to the point of being stuffed, eating filling foods, eating slowly, taking small portions and waiting 20 minutes to see if I'm hungry, learning how to eat mindfully, etc, and applying all of those, my appetite is just too big to lose weight. Although my weight has stabilized and I am no longer gaining weight. I also exercise. It still isn't helping me lose weight. I also know I don't have any medical conditions.

Well, I want to go onto wellbutrin. I used to be on it (and can't remember why I switched antidepressants). I remember it suppressed my appetite. Although I don't expect medications to be a miracle cure, it could really help along my lifestyle changes to lose the extra 25 pounds. It also is sometimes prescribed for ADHD. And although I don't have ADHD, I can be absent-minded and distracted. So I think having something to help with focus would be amazing (and IIRC, my focus was pretty good while on Wellbutrin). FYI, I know Adderall also helps with focus and weight loss, but there's no way in hell I would be able to convince my psychiatrist I have ADHD. I need to stick to what I already have - depression.

If I mention I want to suppress my appetite, he won't prescribe it. Seeing another psychiatrist won't work, either, because they'll get all the notes. And they won't prescribe a medication that suppresses my appetite, either.

So, does anyone have any good excuses for making the switch? Once again, my antidepressant not working, the cost, and side effects won't be good reasons. I'm thinking of maybe saying something about my concentration, and I concentrated well on Wellbutrin and want to try that again. Do you have any other ideas?

TL;DR - I am borderline overweight and my weight will not budge despite seeing a dietitian and implementing those changes as well as exercising (and exceeding the recommended amount both in terms of cardio and strength training). I do not have any medical conditions to cause this, my BMR (how many calories you burn just for existing) is just very low due to being so short. I want to switch to Wellbutrin to suppress my appetite. I am currently on an antidepressant, and the cost, side effects, and it not working won't be good excuses to switch medications as my psychiatrist knows those are not a problem. I also know Wellbutrin treats ADHD. I do not have ADHD, but I want to focus better. I know if I mention I want to suppress my appetite, my psychiatrist will not prescribe the medication. Seeing another psychiatrist won't work either due to my medical history. I've seen my current psychiatrist for nearly a decade. I'm currently thinking of saying that I have trouble concentrating on school work and remember concentrating better on Wellbutrin, but I would like other suggestions as well.

Thanks in advance.

 

[azucaramargo]

Why do you think your psychiatrist would not consider a complaint from you that your current antidepressant "just isn't working the way it has in the past"? That is a common phenomenon.

I was on Zoloft for over 15 years, and my shrink agreed to let me add Wellbutrin to the mix, which was awesome.

You COULD say that another doctor (doesn't have to be a psychiatrist--could even be a family member or friend in the medical field) mentioned Wellbutrin to you & thought you might benefit from it.

In my experience, shrinks will listen when you say your job performance/school performance/ability to meet your financial/familial obligations is suffering.

 

[kkatt]

Remember unless it reaches a point where legal authorities are involved, nobody can make you take any medication.
I once told a doctor I had been buying meds online and that I would continue to do so, or they could prescribe me that medication. I guess it is kinda blackmail, but at least they know you are getting a medication that is most likely to actually be what is advertised on the label.
The other option is to actually buy your preferred med online. Yes, it's a bit shady and might well not be in your best interest, but if you're seriously that determined....

 

[k75]

Why can't you ask to try Wellbutrin in addition to your existing antidepressant? Is there an interaction? Just out of curiosity, what is it you're on now?

I've been prescribed it as an add-on to other antidepressants in the past, when the first drug wasn't working well enough on its own. I didn't have to make any fancy excuses to get it. Just said the first med worked ok but not perfectly, I'd been on Wellbutrin in the past and would like to see if it would help. No problem.

Maybe I just have agreeable doctors. I don't know. The point is, you're the patient and are allowed to request things. Their job is to make sure it's safe and try to come up with a plan to help you. But ultimately, you're in charge of your care and have to advocate for yourself.

Another route is seeing your primary care doctor about your weight issue. There are other meds you could try as well. Hell, I had my primary prescribe Wellbutrin once, separate from my psychiatrist.