Q. I recently was diagnosed with BPD. I was diagnosed with dysthymia about 9 years ago and have been taking SSRI's for nearly 10 years. There has been a steady increase in weight since that time. I was able to take it off when I switched between Prozac and Zoloft but as you said in your one responses, you will eventually gain the weight back because of the SSRI's chemical reaction with your brain.

I am currently on 75 mg per day and know I will be put onto something else or perhaps have my dosage increase. Is there any way to regulate the drug in order to maintain normal body weight? I CRAVE carbohydrates which I understand is also a side effect of SSRI's. I normally weight 130 and currently weigh in at 170 which is NOT a moderate weight gain. I am now considered obese.

A. Weight gain on SRIs is a problem. First things first, however. You would likely benefit from an increase in your Zoloft dosage to higher levels. I usually use between 200 and 300 mg/day in my patients. This may buy you some time--6 to 12 months--of lowered appetite. I have had almost no folks with BPD on Zoloft get well on less than 200 mg/day. If you have headaches, migraines, joint pain, irritable bowel, PMS, or TMJ, they should go away at the correct dosage, too.

Other options are to add Wellbutrin, change to Effexor XR (300-450 mg/day) or use Serzone (500-600 at bedtime).