Weight gain due to taking antidepressants, mood stabilizers, and antipsychotic medications is very common. The problem of weight gain is often postponed when medications are first started; the concept is that it might be better to stabilize your mood and worry about possible weight gain later. However, after a few months, increasing weight gain without any change in exercise or food intake becomes more and more of a problem.
Here are some of the medications taken for depression, bipolar disorder, obsessive-compulsive disorder, and panic attacks that may be causing weight gain:
Currently, Paxil is the worst offender, with Prozac and Zoloft ranking second. Some antidepressants are less likely to affect weight. Effexor and Serzone do not generally cause weight gain, while Wellbutrin can cause weight loss. More than 25% of people taking most types of SSRI antidepressant medications (drugs like Prozac, Lexapro, Paxil, and Zoloft) will experience a weight gain of 10 pounds. or more.
Other antidepressant medications, including Elavil and Tofranil and MAO inhibitors like Parnate and Nardil, can also influence fat storage with short- and long-term use.
Animal and human studies have shown that these medications can cause weight gain through several different pathways:
o Increase carbohydrate cravings.
o Blockade of histamine receptors causes an increase in appetite.
o Move slower, less restless.
o When depression causes weight loss (not very common), improving depression can cause weight gain.
Drugs most commonly associated with weight gain:
Selective serotonin reuptake inhibitors (SSRIs) and weight gain:
The five most common SSRIs currently prescribed in the United States today are as follows:
Citalopram (Celexa®)
o Fluoxetine (Prozac®)
o Fluvoxamine (Luvox®)
o Paroxetine (Paxil®)
o Sertraline (Zoloft®)
Paroxetine (Paxil®) appears to have the most significant impact on weight of all the SSRIs. Some studies even showed an average weight gain over time of 15 to 20 pounds with sertraline (Zoloft), fluoxetine (Prozac®), and citalopram (Celexa®).
Tricyclic antidepressants (TCAs) and weight gain:
TCAs were the most commonly prescribed antidepressants before SSRIs became widely available and were used to treat pain and sleep. There is evidence that they increase carbohydrate cravings and may slow metabolism.
o Amitriptyline (Elavil®)
o Amoxapine (Asendin®)
o Clomipramine (Anafranil®)
o Desipramine (Norepramine®, Pertofrane®)
o Doxepin (Adapin®, Sinequan®)
o Imipramine (Janimine®, Tofranil®)
o Nortriptyline (Aventyl®, Pamelor®)
o Protriptyline (Vivactil®)
o Trimipramine (Rhotramine®, Surmontil®)
Other antidepressants and weight gain:
Other antidepressants that do not strictly fall under the SSRI, TCA, or MAOI classifications include the following:
o Bupropion HCL (Wellbutrin®)
o Mitrazapine (Remeron®)
o Nefazadone (Serzone®)
o Trazadone (Desyrel®)
o Venlafaxine (Effexor®)
Venlafaxine (Effexor®) has been shown to cause weight gain, but not as bad as the SSRIs (Paxil®), fuoxetine (Prozac®), and sertraline (Zoloft®).
Mitrazapine (Remeron®) has been associated with significant weight gain, possibly secondary to interactions with the histamine (H1) receptor
Trazone (Desyrel®) is an antidepressant with sedating properties that is often used as a sleep aid and as a treatment for depression. It appears to cause less weight gain than amitriptyline (Elavil®) but more than bupropion HCL (Wellbutrin®).
Buproprion HCL (Wellbutrin®) has not been associated with weight gain and is commonly used with some success for smoking cessation.
The first solution is to lower the doses and then switch to another drug. (with the help of a doctor). This is not as easy as you might expect. People who have had really bad times with their depression and feel fine are often very reluctant to reduce dosages or switch medications for fear that the “blues” will return. Most people have very individual responses to their medications. So you have to be very careful when adjusting dosages and choosing the “right” drug for the “right” person. For this to work, you need to consult with the doctor who prescribes the medication. Making medication changes without supervision can be dangerous.
Evidence is mounting that increasing daily exercise, even 15 to 20 minutes a day, can have an effect not only on weight loss but also on depression. In a study from Finland, researchers found that men who exercised at least two to three times a week experienced
While experts may not be sure why antidepressants cause weight gain, they do know that switching medications can make a difference.
