Common Side Effects | Common Crazy Med Crap Index | Dealing with Side Effects

1.  I Want a Drug that Works with No Side Effects!

And I want a woman as horny as I am, who cooks as well as I used to, with a nice ass, an equally nice trust fund, and whose main mission in life is making me happy. You’ll probably get a wedding invitation from me before you get a perfect drug.

2.  OK, Can I Get a Drug That Won’t Make Me Fat, Bald, or Asexual?

Will you settle for two and a half out of three? There are five meds that rarely cause weight gain and sexual dysfunctions. Hair loss/thinning is rare with four of them and is uncommon, but still happens with the third. Of course they may be totally inappropriate for you, and their other side effects can even be worse than weight gain, hair loss and sexual dysfunction combined. But here they are:

  • Geodon / Zeldox (ziprasidone). Of all the antipsychotics Geodon seems to be the least likely to cause weight gain and metabolic problems.
  • Wellbutrin (bupropion) is an AD. It is used for smoking cessation under the trade name Zyban. It has a reputation as the skinny, sexy, happy drug.
  • Lamictal (lamotrigine) is an antiepileptic drug (AED)1 used to treat epilepsy (duh), but is mostly used to treat as a mood stabilizer to treat bipolar disorder. This is the one med of the group where hair thinning/loss is an uncommon instead of rare occurrence. Lamictal comes with a shitload of other side effects you may not like; and while it probably won’t make you thinner, weight gain is uncommon. Bonus: like Wellbutrin Lamictal might make you hornier.
  • Keppra (levetiracetam) is an AED used to treat epilepsy. It’s generally not as effective as Lamictal, unless you have one of the oddball forms of epilepsy. Keppra has a super-low side effect profile, and hardly any drug-drug interactions.
  • Neurontin (gabapentin) is another AED with really low side effects, but is mostly used to treat neuropathy and other pain-related conditions. People in those communities don’t bitch about side effects as much, although weight gain, hair loss, and sexual dysfunction are potential problems with only a few of the first-line meds, such as Cymbalta.


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3.  What About Those “Natural” Things?

Haven’t you learned yet that nature is always trying to kill us? The outside is full of poisonous plants, fungi and critters.
Anything that works will have potential side effects of some sort, thus anything with no side effects does nothing beyond the placebo effect.
So let’s take a look at some “natural” things that actually work.

3.1  Omega-3 Fish Oils

Proven to work in treating the high triglycerides associated with heart problems and diabetes, you can get concentrated, prescription-strength EPA under the name Lovaza. That means there’s a PI sheet full of side effects that map nicely to side effects reported all over the place by people taking fish oil for unipolar or bipolar depression. So what do we have: eructation (that’s the “fish burps” everyone writes about), taste perversion, and all sorts of GI problems. Every med has GI problems. The GI problems for fish oil are more likely to stick around than they are for SSRIs. There’s also fecal incontinence, just like Alli (orlistat)2, and one of my favorite freaky rare side effects: sudden death.3

3.2  St. John’s Wort

First of all, ground up St. John’s Wort, assuming that’s what’s in the capsule, isn’t going to do much. The real stuff is pharmaceutical-grade Hypericum extract, such as you would find in Germany, which is sold in, you know, pharmacies. Take a look at this study, and you’ll find that, sure, Hypericum works as well as Zoloft. And it has just as many side effects as any other AD. Even the St. John’s wort extract you can get at a supplement shop causes photosensitivity, really messes with hormonal birth control, and has all sorts of other drug-drug interactions.

3.3  Acupuncture

That’s right, acupuncture. For migraines and neuropathic pain, but not psychiatric disorders. While the data are somewhat mixed, acupuncture seems to work more often than not in the large, controlled studies. Acupuncture has side effects, and not just ones related to being poked with sharp, and occasionally electrified needles, but not the ones people complain about.

Need more information? Skip on ahead to the page about supplements and their interactions with crazy meds.



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4.  Fine. What do You Suggest?

Not basing treatment options entirely on side effects. And I’m more likely to get my wish regarding the trust fund hottie before most people stop putting side effects before efficacy when choosing treatment options. With that in mind, here are the meds with the lowest side effect profiles (i.e. the ones that suck the least) when it comes to treating broad categories of conditions.

4.1  Depression

As mentioned above: Wellbutrin.

4.2  Bipolar Disorder

  • It’s a twofer: Geodon and Lamictal, either individually or together. Lamictal is especially effective for bipolar 2, and that cocktail would be really effective for bipolar 2.
    • The only downside to using Lamictal to treat bipolar disorder is that you need to be stable first. Or at least really fucking depressed for a long-ass time. Otherwise you’ll just get hypomanic-to-manic and/or start cycling.
  • The Lamictal and Wellbutrin cocktail is also popular for bipolar 2.

4.3  Panic/Anxiety

  • BuSpar. It doesn’t have the best efficacy rate around. If it works for me that’s probably a bad sign. But its side effect profile is pretty damn low.
  • A benzodiazepine of some sort. Other than the whole habit-forming aspect, benzos are fairly side-effect free. While far less likely to happen, the discontinuation syndrome for benzodiazepines can be worse than that for SSRIs. The drowsiness usually goes away (which is why they are generally useless as long-term treatments for insomnia). You and your doctor can work out the details based on how intense your anxiety is, how long the symptoms of panic attacks last, etc.
    • Ativan (lorazepam). Lorazepam is an extremely low-key drug. If you’re looking for something you need to take every day, it may or may not be appropriate, but it is a great med to use as required.
    • Klonopin (clonazepam). My choice for a med to take every day, but only because I’m overly cautious.
    • Xanax (alprazolam) is the most effective benzo for daily use, but has the worst discontinuation syndrome of the bunch. So as long as you’re comfortable with the odds of 99 times out of a 100 (if not more so) of not having the discontinuation syndrome…

4.4  Epilepsy

Another twofer: Lamictal or Keppra. While it’s approved only as an add-on, Keppra has had success in treating difficult-to-treat forms of partial and generalized seizures when taken by itself. As with bipolar, Lamictal is better to take after another med gets your seizures under control.

4.5  Neuropathic Pain

Neurontin (gabapentin). While Lyrica (pregablin) doesn’t have the usual side effects people hate, it often makes people feel too stoned to do anything useful. Which may be more feature than bug for some.

4.6  Schizophrenia

  • Geodon
  • Good, old-fashioned Thorazine (chlorpromazine) and Haldol (haloperidol). No, really. Some of the older APs have a really bad reputation they don’t deserve. At the low-to-medium range of their therapeutic dosages Thorazine’s and Haldol’s side effects aren’t really all that bad. It’s when you need much higher dosages that the second-generation APs like Geodon start looking a lot better.


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Common Side Effects | Common Crazy Med Crap Index | Dealing with Side Effects



1 Also called anticonvulsants and, when applied to bipolar disorder, mood stabilizers.

2 And if you're old like I am, you might remember the fat substitute Olestra and the delightful phrase "oily anal leakage."

3 In all fairness to the fish oil, which I take myself, any death was probably due to an allergic reaction. My money is on a lifelong vegetarian, or someone who had just never eaten seafood, who had no idea they were allergic to fish. Then again, it could have been some idiot who knew they were allergic to fish but thought that the "fish" in "fish oil" was a description and not the source. Or the doctor who graduated last in their class and is barely competent enough to practice thought the oil was safe to take because it was in a capsule.


Meds with Fewer Side Effects than Most by Jerod Poore is copyright © 2011 Jerod Poore

Last modified on Friday, 15 April, 2016 at 20:19:49 by JerodPoorePage Author: Jerod PooreDate created: 26 May 2011

All drug names are the trademarks of someone else. Look on the appropriate PI sheets or ask Google who the owners are. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of any trademarks may have changed without my noticing.





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1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.

3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion as anonymity on teh Intergoogles. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.

* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.

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