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Do Methotrexate, Omeprazole And Gabapentin Cause Weight Gain?

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Posted on Thu, 9 Jun 2016
Question: I have been gaining weight so much in the last 6 months. I have gained 30 pounds. I was wondering if my current medications would contribute to some of my weight gain. Here are my current medications:
Baclofen,Tramadol., Methotrexate, Bupropion SR, Vitamin D3, Bupropion XL, Myrbetriq, Atorsvastatin, Folic Acid, Gabapentin, Trazodone, Mirttazapine,Omeprazole, Duloxetine,Linzess,Viibryd, Clonazepam, Stool Softener, Potassium Glucomate
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (1 hour later)
Brief Answer:
Mirtazapine

Detailed Answer:
Hello and welcome,

I am sorry that you have been struggling with weight gain. Several of your meds have the potential to cause some weight gain but one in particular stands out: mirtazapine (Remeron). Mirtazapine is a drug that is well established to be associated with weight gain. In studies, of all of the "newer" antidepressants, it is associated with the most weight gain.

The Buproprion is one of the few antidepressants associated with weight loss, so that is a good choice, but I am wondering if it is an error that you wrote both Bupropion SR and Bupropion XL?

The other antidepressants and gabapentin have the potential to increase weight, but generally not as much as mirtazapine. All together, given the meds you are taking, there could be an increase in weight, but I guess the place you might want to start is seeing about the mirtazapine. I could not find information on whether weight gain with mirtazapine is dose related (i.e. more weight gain associated with higher dosages vs independent of dosage). That might be a question to ask the pharmacist where you get your meds filled. If the weight gain is dose related, then trying to cut down on the dosage might help. Or, you may need to go up on the bupropion.

I hope this information helps.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh (4 minutes later)
Thanks for your answer. I am taking both doses of bupropion. The one strength I take in the a.m. The other is to be taken at 2p.m. Most days I forget the afternoon strength/dose.

What else could it be? My diet has really not changed since I have been gaining weight.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (1 hour later)
Brief Answer:
Other medical conditions

Detailed Answer:
By what else could it be, I am thinking you mean other than medications? Thyroid disorder is the main medical problem that can cause marked weight gain. Cushing's Disease, a disorder of excess production of the hormone cortisol, is another disease that causes weight gain, but you would likely have other signs of this, such as a "buffalo hump" on the upper back. If you want to pursue looking into this, there is a salivary test you can take to check for excess cortisol production. Cushings is a relatively uncommon endocrine disease.




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh (11 hours later)
Do I ask my doctor to order a salivary test? Do most hospitals offer this test? Or do i order it myself. What is the best diet plan?
I have been told my thyroid levels are fine. However, I do have cysts and nodules and inflammation of my thyroid. But nothing is going to be done.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (5 hours later)
Brief Answer:
About salivary cortisol test.

Detailed Answer:
The salivary cortisol test would need to be ordered by your doctor or an endocrinologist.

I see that you listed that you have low potassium levels. This can go with high levels of cortisol which can be from Cushing's or from chronic stress.

About the cysts, nodules, and inflammation in your thyroid, I imagine that this was seen on an imaging study such as ultrasound or CT. Have thyroid autoantibodies been checked (in addition to the usual TSH and thyroxine levels that may have been drawn)?

Do you have an endocrinologist? If your doctor does not know how or want to order the salivary cortisol test, perhaps an endocrinologist would be the next step. However, getting in to see one might take some time.

The salivary cortisol test may not be done by all hospital labs, but that is not a problem because you collect the sample at home (from spit) and can mail it to the appropriate lab that your doctor orders the test from. Or in some cases, the local lab XXXXXXX it for you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh (3 hours later)
I have an endocrinologist. He is not very hands on. If my TSH is normal, he does nothing.
So, I very strongly doubt he would order for the thyriod antibodies or the saliva test.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (35 minutes later)
Brief Answer:
Info

Detailed Answer:
How does your endocrinologist explain the low potassium levels? And the thyroid inflammation?

Perhaps he would be willing to humor you if you ask for those tests specifically?

You asked in your previous note about a diet plan and I forgot to respond. It is best to eat plenty of low glycemic vegetables (pretty much most vegetables are low glycemic except for regular potatoes) and minimize carbohydrates - in particular refined carbs such as sugar and white flour made foods. Fill up on veggies. Protein from legumes (beans, lentils) and fish and some nuts and chicken. Fruit (although not in excess). Oils, such as olive oil are better to have than refined carbs, and oils can keep you full longer.

You may want to make appointments with a nutritionist to help keep you on track.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh (1 hour later)
He does not explain why. I try to get some answers but he has to go to another patient. What again are the name of the tests. I will ask my pcp for a referral to a nutritionist. My ankles ,feet ,hands and fingers are really swelled . They have bee like this for weeks. What would causes this?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (1 hour later)
Brief Answer:
Tests

Detailed Answer:
The names of the tests are
1. Anti-thyroid antibodies
2. 11 PM Salivary Cortisol

Consider calling the endocrinologist's office and asking the nurse if he'll order these. He might be willing to just have her order them.

About the peripheral swelling, how are your kidney tests? Specifically BUN and Creatinine? Swelling is usually due to either a problem with the circulation, lymphatic drainage, or the kidneys not working adequately. It can also be from sodium/salt retention and estrogen/progesterone imbalances. Excess cortisol can do this too. I can give a list, but without the advantage of being able to do a physical exam and see all of your past labs, I wouldn't be able to say what is going on more specifically.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3133 Questions

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Do Methotrexate, Omeprazole And Gabapentin Cause Weight Gain?

Brief Answer: Mirtazapine Detailed Answer: Hello and welcome, I am sorry that you have been struggling with weight gain. Several of your meds have the potential to cause some weight gain but one in particular stands out: mirtazapine (Remeron). Mirtazapine is a drug that is well established to be associated with weight gain. In studies, of all of the "newer" antidepressants, it is associated with the most weight gain. The Buproprion is one of the few antidepressants associated with weight loss, so that is a good choice, but I am wondering if it is an error that you wrote both Bupropion SR and Bupropion XL? The other antidepressants and gabapentin have the potential to increase weight, but generally not as much as mirtazapine. All together, given the meds you are taking, there could be an increase in weight, but I guess the place you might want to start is seeing about the mirtazapine. I could not find information on whether weight gain with mirtazapine is dose related (i.e. more weight gain associated with higher dosages vs independent of dosage). That might be a question to ask the pharmacist where you get your meds filled. If the weight gain is dose related, then trying to cut down on the dosage might help. Or, you may need to go up on the bupropion. I hope this information helps.