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What Does This DNA Test Result Indicate?

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Posted on Tue, 7 Jul 2015
Question: I had a DNA test done that showed results I don't understand, I have been struggling with depression and lack of energy for 6+ months, have gained 20 pounds and am not myself socially or with family as I am very tired and withdrawn. I would like a 2nd opinion on what the results show and what I should take to work for me. I wanted to try SNRI, but afraid of weight gain with that, too. I am currently on Wellbutrin.
doctor
Answered by Dr. Shubham Mehta (1 hour later)
Brief Answer:
all antidepressants can cause weight gain.

Detailed Answer:
Hello
Welcome to HCM.
I can understand your concerns.
I have seen your reports thoroughly.

First regarding the reports, I do not think these reports to be clinically useful.
The reason being that your report shows you have increased risk of side effects (especially weight gain) with atypical antipsychotics.
This is a possibility with every individual irrespective of DNA reports (which is not feasible in every patient).

The report shows that you can do well with most of the drugs (those ticked in green column. These drugs are anyhow the treatment options for anyone.

So, in my opinion, this report does not carry much clinical significance.

Now coming to your treatment part:
All antidepressants can cause weight gain (SSRIs, SNRIs, TCAs etc.) except wellbutrin which is considered to be weight neutral.

Before adding any other drug, I would suggest a dose increment of zoloft.
The maximum dose of zoloft for depression is 200mg.

If there is still no effect with maximum dose, then you can think of SNRI like desvenalfaxine (do not worry about weight gain specifically with SNRIs because every antidepressant can cause weight gain).

To prevent weight gain, you would have to go for daily physical exercises and avoid fatty and junk food.

Kindly discuss this with your psychiatrist.

Hope I am able to clear your confusion to some extent.

Feel free to ask further.

I wish you well.
Thanks.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Shubham Mehta (25 minutes later)
Yes, this helps. I am on wellbutrin 300 mg. now. Are you suggesting this Zoloft increment to take in combination with the wellbutrin?

I have tried that before, and my doctor added that before, and that is what caused my weight gain. I haven't added it again yet as I wanted to wait for these results before adding anything new.

I will check with my PA, also, but does it appear that would be a good combo for me? If you think better (based on some of those results) and know what drugs work on what, please let me know if you think Zoloft be better to try in combo with the wellbutrin or if Effexor XR would be a good combo with the wellbutrin?

If you take SNRI with wellbutrin is that too much on nephenephrine? Just curious as I am willing to add anthing that will increase my energy and Zoloft did not. Thanks.

doctor
Answered by Dr. Shubham Mehta (9 hours later)
Brief Answer:
effexor not a good choice.

Detailed Answer:
Hi again.

As per your reports, the atypical antipsychotic drugs can cause adverse effects (especially weight gain) in you.
(This is anyhow the fact that antipsychotic drugs cause weight gain in all).

Regrading combination, drugs those ticked in green column are safe for you.

You have been given high dose of zoloft in past which led to weight gain, without much improvement in symptoms.
(You did not mention this in your query earlier).

Increasing the dose of zoloft again is not a good idea then.

Effexor with wellbutrin can cause potential drug interactions. I would not recommend this combination.
Pristiq (desvenlafaxine) in low doses is relatively safe and better tolerated then effexor.

Stimulants can also be considered in your cases.
But I would prefer armodafinil (very less abuse potential) over dexedrine (more abuse potential).

Kindly discuss this with your doctor.

Feel free to ask further.
I wish you well.
Thanks.
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Shubham Mehta (19 hours later)
Thank you, I will inquire on that perhaps. If I just remain on the 300 mg. Wellbutrin, as since the report also suggested dexadrine I read that to mean that I was dopamine low? Is that what that means? I also wondered if it means I have ADHD, since it also recommends stimulants and Omega 3? Please let me know your thoughts on that. If I am dopamine low, wellbutrin works on that and I'll just try to increase my serontonin with other ways. What are ways for that? Exercise? I hear certain foods, too? I think this is my last question in the payment I made, please advise on these and I appreciate it.
doctor
Answered by Dr. Shubham Mehta (3 hours later)
Brief Answer:
wellbutrin alone would not be sufficient.

Detailed Answer:
You are most welcome.

Your report recommends use of dexedrine.
But this does not indicates that you are low in dopamine.
Neither does it suggests that you have ADHD.
ADHD is a clinical diagnosis primarily and is diagnosed on basis of criteria laid in DSM/ICD.

I do not think wellbutrin alone would be sufficient for you. It is a weaker antidepressant as compared to others.

Your report has listed almost all the antidepressants and their possibility of use in your case.
Stimulants and omega-3 fatty acids are among those. But then, these are not the first line or even second line antidepressants.

I doubt that natural ways to elevate serotonin would be enough.
Exercises or simple brisk walking for 30 minutes, some foods like legumes and potatoes can help to increase serotonin.
Avoid caffeine. Ensure adequate exposure to light.
These strategies are just supplementary and does not replace drugs.

So, in my opinion,
Wellbutrin alone would not be sufficient.
Add pristiq or a stimulant (preferably armodafinil).
Exercise regularly.

Discuss these issues with your doctor.

You can confirm about number of follow-up questions from the site moderators.

Hope my suggestions have helped you.

Kindly close the discussion if you have no more queries and give your valuable feedback.

Take care.
Thanks.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shubham Mehta

Psychiatrist

Practicing since :2008

Answered : 2145 Questions

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What Does This DNA Test Result Indicate?

Brief Answer: all antidepressants can cause weight gain. Detailed Answer: Hello Welcome to HCM. I can understand your concerns. I have seen your reports thoroughly. First regarding the reports, I do not think these reports to be clinically useful. The reason being that your report shows you have increased risk of side effects (especially weight gain) with atypical antipsychotics. This is a possibility with every individual irrespective of DNA reports (which is not feasible in every patient). The report shows that you can do well with most of the drugs (those ticked in green column. These drugs are anyhow the treatment options for anyone. So, in my opinion, this report does not carry much clinical significance. Now coming to your treatment part: All antidepressants can cause weight gain (SSRIs, SNRIs, TCAs etc.) except wellbutrin which is considered to be weight neutral. Before adding any other drug, I would suggest a dose increment of zoloft. The maximum dose of zoloft for depression is 200mg. If there is still no effect with maximum dose, then you can think of SNRI like desvenalfaxine (do not worry about weight gain specifically with SNRIs because every antidepressant can cause weight gain). To prevent weight gain, you would have to go for daily physical exercises and avoid fatty and junk food. Kindly discuss this with your psychiatrist. Hope I am able to clear your confusion to some extent. Feel free to ask further. I wish you well. Thanks.