Antidepressant medication and weight increase: Understanding the link
In the United States, antidepressants are the third most commonly prescribed drugs, and while they play a crucial role in managing mental health, they can also have an impact on a person's weight.
One potential side effect of antidepressants is weight gain. Tricyclic antidepressants (TCAs) and Monoamine oxidase inhibitors (MAOIs) have been linked to the greatest amount of weight gain. TCAs such as amitriptyline (Elavil) and nortriptyline (Pamelor), and MAOIs like phenelzine (Nardil) are associated with significant weight gain, with patients reporting an average of 7 to 10 kilograms when using these drugs for an extended period.
Certain Selective serotonin reuptake inhibitors (SSRIs) like paroxetine (Paxil), citalopram (Celexa), and sertraline (Zoloft) have also been associated with weight gain, especially with long-term use. For instance, adults taking sertraline for two years gained an average of 5.9 pounds. However, other SSRIs like escitalopram (Lexapro) are considered more weight-neutral.
Some serotonin-norepinephrine reuptake inhibitors (SNRIs) like duloxetine (Cymbalta) and venlafaxine (Effexor) may also cause weight gain, though this is less consistently observed than with TCAs or MAOIs.
In contrast, bupropion (Wellbutrin) is among the antidepressants least likely to cause weight gain and may even cause weight loss in some patients.
The atypical antidepressant mirtazapine (Remeron) is well-known for causing increased appetite and weight gain, and it is sometimes used off-label as an appetite stimulant.
Exercise can help improve mood and reduce depression, and may be helpful in managing weight gain associated with antidepressants. It is important to consult a doctor before making changes to medications, diet, and levels of physical activity while on antidepressants.
Approximately 25 percent of people using antidepressants experience an increase in weight. Experts do not fully understand why antidepressants lead to weight gain in some people.
While depression itself may cause weight gain in some people and weight loss in others, it is crucial for individuals to discuss the side effects of antidepressant medications with their doctor before beginning treatment.
For those concerned about weight gain, antidepressants such as bupropion or weight-neutral SSRIs (e.g., escitalopram) might be preferable options, whereas TCAs, MAOIs, paroxetine, and mirtazapine carry a higher risk of weight gain.
Here is a summary table of the weight gain potential for different classes of antidepressants:
| Antidepressant Class | Examples | Weight Gain Potential | |-------------------------------|------------------------------|------------------------------| | Tricyclic antidepressants (TCAs) | Amitriptyline, Nortriptyline | High | | Monoamine oxidase inhibitors (MAOIs) | Phenelzine | High | | Selective serotonin reuptake inhibitors (SSRIs) | Paroxetine, Citalopram, Sertraline | Moderate to High | | Selective serotonin-norepinephrine reuptake inhibitors (SNRIs) | Duloxetine, Venlafaxine | Moderate | | Atypical antidepressants | Mirtazapine | High | | Others | Bupropion (Wellbutrin) | Low or causes weight loss |
References: [1] American Psychological Association. (2018). Antidepressants. Retrieved from https://www.apa.org/topics/antidepressants [2] Mayo Clinic. (2021). Antidepressants: Side effects. Retrieved from https://www.mayoclinic.org/drugs-supplements/antidepressants/evx-20390262 [3] National Institute of Mental Health. (2021). Depression. Retrieved from https://www.nimh.nih.gov/health/topics/depression/index.shtml [4] WebMD. (2021). Antidepressant Weight Gain. Retrieved from https://www.webmd.com/depression/guide/antidepressant-weight-gain#1
- The science of health-and-wellness reveals that certain antidepressants, such as tricyclic antidepressants (TCAs) and Monoamine oxidase inhibitors (MAOIs), can have a significant impact on a person's weight, potentially leading to weight gain.
- The list of antidepressants associated with weight gain includes medications like paroxetine (Paxil) and sertraline (Zoloft), which are categorized as Selective serotonin reuptake inhibitors (SSRIs).
- In comparison, Selective serotonin-norepinephrine reuptake inhibitors (SNRIs) like duloxetine (Cymbalta) and venlafaxine (Effexor) may cause some weight gain, though the risk is less consistent than with TCAs or MAOIs.
- Bupropion (Wellbutrin), an atypical antidepressant, is less likely to cause weight gain and may even contribute to weight loss in some individuals.
- Mental health professionals might suggest weight-neutral SSRIs, such as escitalopram (Lexapro), or bupropion as alternatives for individuals concerned about weight management while using antidepressants.
