HomeBlogPatientDo Antidepressants Cause Weight Gain? Do Antidepressants Cause Weight Gain? March 12, 2018Patient Table of Contents Why Do Some Antidepressants Cause Weight Gain? Antidepressants More Likely to Cause Weight Gain Antidepressants Less Likely to Cause Weight Gain Ways to Avoid or Limit Weight Gain While Taking Antidepressants It’s top of mind for many people who have been prescribed antidepressants: Will I gain weight while taking this drug? Most antidepressants list weight gain as a potential side effect of use, however not everyone gains weight when taking antidepressants. “Based on my clinical experience, about a third of people typically gain weight when taking an antidepressant,” says Dr. Andrew Morson, a New Orleans-based psychiatrist.” “Any side effect – weight gain included – depends entirely on how your body reacts to the medication,” writes Nancy Schimelpfening in Verywell mind. “It is possible that you will notice no change in weight or that you will swing in the opposite direction of what’s typical, no matter what medication you take.” Since antidepressants are a significant component of many depression treatment plans, and concern over gaining weight is prevalent, it is important to understand the issues and possible ways to manage the role weight gain plays in antidepressant use. Why Do Some Antidepressants Cause Weight Gain? Scientific data regarding why some people gain weight when they take antidepressants is confusing at best. While there are multiple conflicting research studies that examine if antidepressants cause weight gain, it is difficult to find research that answers the question of why weight gain happens for some antidepressant users. A 2016 research study published in Translation Psychiatry claims that “despite the concomitant rise of antidepressant use and of the obesity rates in Western societies, the association between the two, as well as the mechanisms underlying antidepressant-induced weight gain, remain under explored.” An article in Medical News Today states that, while experts are not clear on the reasons for the correlation between antidepressants and weight gain, “one theory is that both metabolism and hunger levels may be affected. … Antidepressants interfere with serotonin, the neurotransmitter that regulates anxiety and mood while also controlling appetite. In particular, these changes may increase cravings for carbohydrate-rich foods, such as bread, pasta, and desserts.” Another theory, according to the article in Medical News Today, is that some depressed people lose their appetite, so when the antidepressants start to work, they may grow hungry again, eat more, and gain weight. The author notes that “depression can lead to fatigue and inactivity, and a lack of physical activity can cause weight gain. Antidepressants More Likely to Cause Weight Gain While the evidence is still uncertain regarding the connection between weight gain and specific antidepressants, “some drugs were more strongly associated with weight gain than others,” according to a Time Magazine article that discusses a study published in the British Medical Journal (BMJ). The Time Magazine article notes that, “the study comes with many caveats” but finds that “antidepressant use may be associated with weight gain over time.” The Medical News Today article lists the following antidepressant medications as more likely to lead to weight gain: Tricyclic antidepressants (TCAs): “amitriptyline (Elavil), amoxapine, desipramine (Norpramin), doxepin (Adapin), imipramine (Tofranil-PM), nortriptyline (Pamelor), protriptyline (Vivactil), trimipramine (Surmontil)” These antidepressants, which have been shown to be effective, especially for people who don’t respond well to other medications, have been around for a long time and are not prescribed as frequently as others due to side effects such as weight gain. “Older research suggests that excessive weight gain caused many users to quit TCA treatment.” Monoamine oxidase inhibitors (MAOIs): “isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate)” Like Tricyclic antidepressants, these are from an earlier class of antidepressants and can help relieve depression in people who don’t respond well to other medications. However, MAOIs aren’t used as regularly due to adverse side effects. Conversely, “one type of MAOI called selegiline (Emsam), a topical treatment that is applied to the skin as a patch, has been associated with weight loss in some users.” Selective serotonin reuptake inhibitors (SSRIs): “citalopram (Celexa), fluoxetine (Prozac), paroxetine (Brisdelle, Paxil, Pexeva), sertraline (Zoloft)” In the short term, these commonly prescribed antidepressants, “have been associated with weight loss . . . but may cause weight gain when used long term.” According to a 2017 longitudinal study published in British Medical Journal Open, “SSRIs use was associated with weight gain in the presence of unhealthy behaviors including Western diet, sedentarism and smoking.” Atypical Antidepressants: “mirtazapine (Remeron)” Thought to be less likely to cause weight gain than TCAs, mirtazapine has been “linked to both increased appetite and weight gain.” Antidepressants Less Likely to Cause Weight Gain The Medical News Today article also lists antidepressants that are less likely to lead to weight gain. They include: “desvenlafaxine (Pristiq) escitalopram (Cipralex, Lexapro) levomilnacipran (Fetzima) nefazodone (Serzone) venlafaxine (Effexor) venlafaxine ER (Effexor XR) vilazodone (Viibryd) vortioxetine (Trintellix)” They also state that the SSRIs citalopram (Celexa), fluoxetine (Prozac), and sertraline (Zoloft) are unlikely to cause weight gain if used for fewer than six months. And some depression drugs, the Medical News Today article reports, “have been associated with weight loss, including: bupropion (Aplenzin, Forfivo, Wellbutrin), duloxetine (Cymbalta), selegiline (Emsam).” Ways to Avoid or Limit Weight Gain While Taking Antidepressants Antidepressants are often an important part of depression treatment. According to the Time Magazine article, Rafael Gafoor, a primary care and public health researcher at King’s College London and co-author of the BMJ study, indicated that, “the risk of weight gain should not necessarily discourage people from taking antidepressants, but patients should discuss the risk of weight gain with their doctors when beginning a new treatment plan, and potentially develop long-term strategies for keeping it in check.” Additionally, as noted in the Medical News Today article, “if a person feels that the benefits of the medication, such as being able to manage their depression, outweigh the side effects, a doctor may advise them to address any weight gain by dietary changes and more physical activity.” Gafoor was also noted as saying that “a variety of factors need to be taken into account when prescribing any given antidepressant, so the best advice is to have an open, informed conversation with your prescriber if weight gain (or any other side effect) is bothersome.” However, if a patient does want to stop their medication due to side effects, Dr. Jesse Wright, M.D., Ph.D. told Self Magazine that “it’s not a good idea to stop abruptly.” Like Gafoor, he suggests talking to your doctor as you did when you made the decision to start antidepressants. Together, you can develop a tapering off strategy to avoid ill effects. Dr. Wright emphasizes the importance of treatment because “depression can take a big toll on people’s lives.” “Stopping antidepressants before you’re ready also makes it more likely that you’ll experience a relapse of depression,” reports Self Magazine. “Whether you’re using antidepressants or other methods to manage your depression, listening to your body and communicating openly and often with your doctor are key.” For more information about antidepressants, please read the following articles on the GeneSight blog: https://genesight.com/blog/how-do-antidepressants-work/ https://genesight.com/genetic-insights/how-your-body-metabolizes-antidepressants-and-the-role-your-genes-play/ https://genesight.com/blog/patient/5-things-to-know-before-starting-antidepressants/ Our articles are for informational purposes only and are reviewed by our Medical Information team, which includes PharmDs, MDs, and PhDs. Do not make any changes to your current medications or dosing without consulting your healthcare provider. The GeneSight test must be ordered by and used only in consultation with a healthcare provider who can prescribe medications. As with all genetic tests, the GeneSight test results have limitations and do not constitute medical advice. The test results are designed to be just one part of a larger, complete patient assessment, which would include proper diagnosis and consideration of your medical history, other medications you may be taking, your family history, and other factors. If you are a healthcare provider and interested in learning more about the GeneSight test, please contact us at 855.891.9415. If you are a patient, please talk with your doctor to see if the GeneSight test may be helpful. Patient Which Mental Health Provider Should I Consider? 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Patient Which Mental Health Provider Should I Consider? A Symptom-Based Guide The support of a good healthcare provider can make all the difference when you’re struggling with your mental health. But how do you connect to one in a sea of ... Read more
Patient One explanation for why we experience Side Effects? Understanding Your Genetic Response to Antidepressants Antidepressants often play an essential role in helping patients with their mental health conditions. But as many patients can attest, it’s frustrating when... Read more
Patient Barriers at Every Turn: How Systemic and Social Factors Block Men from Mental Health Care Taking the important step of seeking care for mental health isn’t always an easy decision. Uncertainty about the need for care, social stigmas associated wi... Read more
Healthcare Provider Overcoming Side Effect Concerns: Leveraging Pharmacogenomic Insights to Inform Depression and Anxiety Medication Selection Whitnee Brown, a lifelong resident now practicing in Birmingham, Alabama has nearly an entire alphabet following her name, abbreviations for degrees and certifi... Read more
Patient Concerns about Mental Health Medication Side Effects Remain a Barrier to Getting Help for Those Diagnosed with Depression and Anxiety Lisa Roberts has raised a family, reached an impressively high level in her career, and was an anchor for her mother and other family members. When, within ... Read more
Patient Common Antidepressant Side Effects Taking an antidepressant can be an effective way to help treat a mental health condition like depression or anxiety. However, these medications can also cre... Read more
Patient MTHFR Mutations: Clinical Implications and Management Strategies MTHFR mutations—changes in the methylenetetrahydrofolate reductase (MTHFR) gene—have gained increased attention in the medical community due to their potent... Read more
Patient Can an App Help Me Manage My Anxiety? Health and wellness smartphone apps have become so common that if you can name a health goal, desire or condition, you can probably find an app for it. N... Read more
Patient Black Trailblazers of Psychiatry and Mental Health: A Legacy of Healing and Advocacy As we celebrate Black History Month, we want to recognize a few individuals who have made extraordinary contributions to the field of psychiatry and mental heal... Read more
Patient Mindful Moments: Tips for Anxiety If a well-meaning friend or family member has ever told you to “just breathe” when you’re feeling worked up or stressed out, you’d be forgiven if you felt l... Read more