Antidepressants and Weight Increase: Essential Information You Should Be Aware Of
Antidepressants are a common treatment for depression and anxiety, but they can come with potential side effects, including weight gain. It's essential to understand that not everyone who takes antidepressants will experience weight gain, and it's not the case for everyone that taking antidepressants will cause weight gain.
If weight changes are causing concern, it's crucial to discuss them with a healthcare provider. Other factors, such as mental health conditions, aging, and lifestyle choices, can also contribute to weight gain. However, the medication itself may play a role, and different antidepressants vary in their potential to cause weight gain.
Among commonly prescribed antidepressants, mirtazapine (Remeron)—a tetracyclic antidepressant—has the highest risk of causing weight gain, associated with a 1.5 times greater chance of gaining at least 5% body weight within a year compared to placebo. Certain SSRIs like citalopram (Celexa) and escitalopram (Lexapro) also have elevated risks, about 1.23 to 1.26 times higher. Other SSRIs such as fluoxetine (Prozac) and sertraline (Zoloft) are linked with somewhat lower but still increased risks, between 1.20 and 1.21 times higher. Tricyclic antidepressants (TCAs) like amitriptyline (Elavil) and nortriptyline (Pamelor) also contribute to weight gain but to a lesser extent (about 1.10 to 1.17 times higher risk). SNRIs such as duloxetine (Cymbalta) and venlafaxine (Effexor) show similar moderate risks (~1.15 to 1.23 times).
Regarding aripiprazole (Abilify), often used adjunctively, weight gain depends on dose, duration, and whether it is combined with antidepressants like citalopram or venlafaxine. Weight gain averages vary widely but can be up to several kilograms, especially in normal or underweight individuals starting treatment.
Other factors influencing weight changes in people taking antidepressants include the severity of depression, appetite stimulation, metabolic changes, lifestyle factors, and baseline body weight. Depression itself may affect appetite, eating habits, and sleep, which can lead to weight changes independently of medication effects. Many antidepressants increase appetite and cravings, sometimes for carbohydrates or sugary foods, contributing to weight gain. Antidepressants can also alter metabolism, causing the body to store more fat. Changes in activity level, diet, and sleep quality during treatment can also influence weight. People who are normal or underweight before starting some medications may experience more significant gains than those already overweight.
In summary, mirtazapine and certain SSRIs (citalopram, escitalopram) are among the antidepressants with the highest weight gain potential, while TCAs and SNRIs show moderate risk. Weight gain results from a combination of drug effects and patient-specific factors like depression severity, appetite changes, metabolism, and lifestyle.
It's essential to focus on how one feels and if the medication is helping address symptoms of depression or anxiety, rather than overly fixating on weight. Improved emotional state while taking antidepressants may make it easier to adopt lifestyle changes. Maintaining a healthy diet, exercise routine, reducing stress, and getting enough sleep can help prevent weight gain while taking antidepressants.
Bupropion (Wellbutrin), which is an NDRI, is associated with lower weight gain compared to some other antidepressants. If weight loss was present before treatment, weight gain may simply be an indicator of improved appetite. If you experience rapid or significant weight gain while taking antidepressants, it's important to talk to your healthcare provider.
A 2024 study shows that weight increases, typically minor, average about 3 pounds within two years of starting a medication. Sertraline (Zoloft) and fluoxetine (Prozac) are types of antidepressants that may cause weight gain, with average weight gain being 3.2 pounds in 24 months for Zoloft. Escitalopram (Lexapro) and paroxetine (Paxil) are types of antidepressants that may cause weight gain as well.
The goal is to find a balance where both mental and physical health are supported. Do not stop taking medication or make changes to it without consulting a healthcare provider. The focus should be on finding the right treatment that effectively manages symptoms of depression and anxiety while minimising potential side effects like weight gain.
- In discussions with a healthcare provider, it's crucial to address any concerns about weight changes, as factors like mental health conditions, aging, lifestyle choices, and the specific antidepressant being taken can all contribute to weight gain.
- Bupropion (Wellbutrin), an NDRI, is associated with lower weight gain compared to some other antidepressants, potentially making it a preferred option for those concerned about potential weight gain.
- A 2024 study revealed that common antidepressants like sertraline (Zoloft) and fluoxetine (Prozac) may cause minor average weight gains of about 3.2 pounds within two years, while other antidepressants like escitalopram (Lexapro) and paroxetine (Paxil) could contribute to similar weight gains.
