Tip For Choosing An Antidepressant
The results of this study indicate that worries about weight gain shouldnt influence the choice of antidepressant for most people. One antidepressant is generally as effective as another. If you need to choose an antidepressant, let cost and potential side effects be your guide.
Many antidepressants are available as generics. Generics work as well as brand name drugs, but cost less.
Here are some tips for choosing a treatment based on common side effects:
- Sexual side effects, such as difficulty having an orgasm. Bupropion may be less likely to cause this side effect. Its also the one associated with the least amount of weight gain.
- Sleepiness. Some antidepressants make you sleepy. If you have trouble falling asleep or staying asleep, taking one of these before bed, like trazodone, might be a good idea. Paroxetine is another good choice.
- No antidepressant leads the pack in terms of being more stimulating. Perhaps bupropion or fluoxetine might be a good first choice.
If you start taking an antidepressant, dont expect to see a major improvement right away. It often takes 6 to 8 weeks to see a response to an antidepressant. And dont give up if the first one doesnt work. Trying a different one may do the trick.
Another option to consider is psychotherapy, especially if the first drug doesnt work. People who do not respond to the first antidepressant can often do as well with talk therapy as they would with another drug.
Antidepressants Cause Minimal Weight Gain
- By Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing
ARCHIVED CONTENT: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date each article was posted or last reviewed. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
Antidepressants have helped millions of people cut through the dark fog of depression. Many others try these medications but stop taking them, often because of side effects such as weight gain. A study from a Harvard-based team shows that the amount gained is usually small, and that it differs little from one antidepressant to another.
Earlier studies linking antidepressant use to weight gain were usually small and short. This one, led by researchers with Massachusetts General Hospitals Center for Experimental Drugs and Diagnostics, included more than 19,000 men and women and lasted for a year.
The researchers chose citalopram as a reference, because earlier studies suggested that it is average when it comes to weight gain. In this study, the weight gain experienced by people taking citalopram averaged one to two pounds. Compared to citalopram, the weight gain linked to other antidepressants was small.
Not everyone taking antidepressants gained weight. Some actually lost a few pounds.
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Antidepressants And Weight Gain: The Diet And Exercise Link
Not surprisingly, experts also say that some of the same tenets that help us control our weight under normal circumstances may also help us while using antidepressants — including eating healthy and getting enough exercise.
“The best thing you could do would be to head off the weight gain before it starts by switching to a more nutritious diet and increasing your daily exercise as soon as you start taking an antidepressant,” says registered dietitian Samantha Heller, MS, RD.
If, in fact, you’ve already started packing on the extra pounds, Heller says switching to a healthier diet, cutting calories, and increasing exercise are still worth the effort.
“Even if you don’t lose weight immediately, you can begin controlling the gain and help your body to stabilize for a while,” says Heller.
Moreover, a steadily growing body of scientific evidence suggests that increasing your daily exercise may affect not only weight loss, but also help your depression. In one large study of more than 3,400 Finnish men and women published in the journal Preventive Medicine, researchers found that those who exercised at least two to three times a week experienced significantly less depression, anger, and stress than those who exercised less frequently or not at all.
Experts warn, however, not to severely restrict caloric intake while taking antidepressants. Not only may this affect brain chemistry in a negative way, any strong sense of deprivation may contribute to feelings of depression.
Can Antidepressants Lead To Weight Loss
Well, it depends on the individual. Antidepressants can cause a range of different side effects, and weight loss is just one of them. People have different reactions to antidepressants, with some patients experiencing no side effects whatsoever.
While most antidepressants are linked to weight gain, a few have been linked to weight loss. These include fluoxetine, bupropion, and duloxetine.
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Important Safety Information For Bupropion Sustained
Warning: Suicidal Thoughts and Behaviors
Suicide is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide. In short-term studies, antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults under age 24. These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients over age 24 there was a reduction in risk in patients 65 and older.
Patients of all ages being treated with antidepressants should be observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially early during antidepressant treatment and when the dose is adjusted up or down. Families and caregivers of patients should look for the emergence of symptoms on a day-to-day basis, since changes may be abrupt.
What You Can Do
Psychiatrist and addiction expert Michael McGee, MD, agrees that weight gain is a real problem with many of the medications he prescribes. Women get especially concerned about it, admits Dr. McGee, who is also the chief medical officer at the Haven Treatment Center in California and the author of The Joy of Recovery. Some patients can eventually go off antidepressants by adopting evidence-based lifestyle interventions to prevent weight gain, he says.
I recommend the Mediterranean Diet because it has antidepressant qualities and I encourage good eating habits like eating slowly and mindfully, avoiding red light foods with lots of added sugar or foods that are overly processed, he explains, adding that its also important for patients to make friends with hunger. Accepting that a little hunger is OK and is necessary to maintain weight. Dr. McGee also recommends spending time in nature, becoming involved in a spiritual community and connecting with others through volunteer work or by socializing with friends.
Be sure to voice your concerns with your physician. Ask your prescribing doctor if there is more than one option and if they can recommend an antidepressant that isnt associated with weight gain. If your doctor feels the most effective medication is one that has been found to cause weight gain in some people, start taking preventative steps right away.
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Talk To Your Prescribing Physician
With safety and effectiveness so well-established, many physicians have become comfortable prescribing antidepressants to their patients. Unfortunately, not all are as comfortable with treating the unwanted side effects.
If you experience weight gain while on antidepressants, it is important to have a candid conversation with your prescriber. Equally important is that you feel your prescriber understands your concerns and is willing to work with you to develop a plan.
Healthcare providers are not all equal when it comes to dealing with antidepressant side effects. Many healthcare professionals will be more focused on treating depressive symptoms than on minimizing weight-related side effects.
Questions you might ask your doctor include:
- Are these side effects normal for this medication?
- Is there anything you can do to help minimize the side effects?
- Are there other medications that might be as effective?
- Would changing the dose help reduce side effects?
Talking to your doctor about your concerns can help you better understand your situation and come up with a plan to help address weight gain.
If you dont believe your doctor is taking your concerns about weight gain seriously, it may be time to get a second opinion.
Antidepressants And Weight Loss: If At First You Don’t Succeed
Although all the experts WebMD consulted believe it’s certainly worth making any and all efforts to control your weight while taking antidepressant medications, they also point out that for one subgroup of people, weight gain will simply be an inevitable side effect of treatment.
“There are clearly some people for whom certain antidepressants are essential, even though the impact on their weight can be so strong that it simply can’t be offset by any amount of calorie restricting or even exercise. It just doesn’t work,” says Sussman.
If this turns out to be true for you, Fincham says it’s vital to keep it in the proper perspective and recognize the importance of treating your depression first and foremost.
“Seeking help for depression and following through with your medication regimen is a courageous and important thing to do, so even if you gain weight in the process, give yourself the gift of working through the depression first. Get a handle on it as best you can, and then worry about the weight loss after you are feeling better mentally and emotionally,” says Fincham.
Sussman agrees. “You have to recognize that the weight gain is not your fault and that what you are doing to help overcome your depression is far more important,” he says.
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Antidepressants And Weight Gain: What Happens And Why
Although there are a number of theories as to why antidepressants lead to weight gain, Sussman believes that both appetite and metabolism may be affected.
“I have had patients who swear that they are not eating any more, but still gaining weight, so that tells us there is some kind of metabolic influence going on I have also had patients tell me that they are not only more hungry and eating more, but that the medicines are encouraging a carbohydrate craving that is hard to control, so we know appetite also plays a role,” he says.
Fincham says antidepressants may also simply help us to rediscover pleasure in our life — including food.
“It might be a situation where someone feels so much better when taking an antidepressant that lots of things suddenly start feeling more pleasurable to them, and food is just one of them. So in this instance they may actually be overeating and not even realize they are doing so, says Fincham.
Findings from a group of Italian researchers published in the journal Psychotherapy and Psychosomatics suggest that the simple act of recovery from depression may play a role in the weight gain.
Depression Medications That Do Not Cause Weight Gain
Talk about depression medication and among the first few things that come to your mind is weight gain. However, one wonders whether there are medicines that treat depression, but which do not contribute to weight gain. The answer to this will be discussed in the following article.
Talk about depression medication and among the first few things that come to your mind is weight gain. However, one wonders whether there are medicines that treat depression, but which do not contribute to weight gain. The answer to this will be discussed in the following article.
Antidepressants refer to a class of drugs which help in reducing the symptoms of depression. A majority of them cause weight gain. However, there are a few that have a relatively less impact on weight.
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Why Wellbutrin Or Prozac May Be The Most Sensible Options
Many people with depression have worked hard to treat their disease. You may attend therapy and take your antidepressants, only to find that the numbers on the scale are moving up and your clothes are not fitting like they used to. While you may feel better emotionally and mentally, you might also feel discouraged by your physical appearance or health.
Some of this may be due to the connection between antidepressants and weight gain. It is not a side effect of every medication used to treat depression, and some are more associated with weight loss.
However, any side effectweight gain includeddepends entirely on how your body reacts to the medication. 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 which medication you take. For some people, the fluctuation in weight is only temporary.
Antidepressants That Cause Less Weight Gain
First of all, we need to establish a relationship between antidepressants and weight gain. Although SSRIs supposedly cause weight loss, there are contradictory views. One of the arguments says that when there is atypical depression, resulting in overeating and excessive sleeping and it is treated by SSRIs, it causes loss in weight. This is a result of uniform levels of serotonin. On the flip side, the link between selective serotonin reuptake inhibitors and weight gain cannot be ignored. If an individual has been taking such medicines for 6 months or more, this side effect is experienced. However, that does not mean that there are no options which cheer you up as well as keep the weight away.
All said and done, SSRIs that do not affect the weight much are Zoloft, Luvox, Escitalopram, and Citalopram. In addition to that, Effexor, Cymbalta, Serzone, and Desyrel also fall in the category of medications resulting in neither weight loss nor gain.
SSRIs lead to weight loss precisely as a result of their side effects which are nausea, loss of appetite, and diarrhea. Wellbutrin, amongst others is another option that does not lead to gain in weight. Bupropion, an antidepressant drug is marketed as Wellbrutin. This is a dopamine reuptake inhibitor and DRIs are known to suppress appetite. Owing to this appetite suppressant property, Wellbrutin is among the antidepressants that fall in this list.
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Weight Changes As Adverse Effects Of Antidepressants
c shows that subjective reports of weight gain and weight loss as adverse effects of antidepressants accurately reflected actual measured weight changes. Among nortriptyline-treated participants, 127 reported undesired weight gain linked to the use of nortriptyline and these individuals gained on average 1.78 kg . Of the 95 individuals who gained 2 kg during nortriptyline treatment, 78 reported weight gain as an adverse effect. Among escitalopram-treated participants, 135 reported undesired weight gain linked to the use of escitalopram and these individuals gained on average 0.92 kg . Of the 51 individuals who gained 2 kg during treatment with escitalopram, 37 reported weight gain as an adverse effect. Weight gain was significantly more often reported as an adverse effect of nortriptyline than of escitalopram .
How To Avoid Weight Gain On Psych Meds
Asking for a referral to a qualified weight loss program in your area is a good idea, says Dr. McGee. What else?
- Focus on what and how you eat
- Don’t eat for gratification, boredom, or self-soothing or overeat to punish yourself
- Discuss whether weight loss medicines, in addition to the structured weight loss program, may be appropriate, at least to start.
According to Dr. Gonzalez-Campoy, ”along with a prescription for antipsychotic medications and most antidepressants, a concomitant prescription for weight management should be provided .”
And for those on antipsychotics, you should be made aware of the health risks that come with significant weight gain such as the development or worsening of high blood sugar, high blood pressure, and high cholesterol, he says. These are medical issues that should be monitored as well, he says.
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Zoloft And Weight Gain: The Basics
SSRIs and other antidepressants have long been associated with changes in body composition and weight gain.
Although newer antidepressants such as sertraline arent as closely associated with weight gain as older drugs, research does show that theres a link between sertraline use and an increase in body mass.
In a study published in the Journal of Clinical Medicine in 2016, researchers compared different antidepressants to assess their effects on body mass.
Sertraline was one of several drugs linked to weight gain, with users of the drug experiencing a modest weight gain over the course of two years when compared with the reference treatment Fluoxetine, a first-generation SSRI.
Although this study isnt perfect , it does show that sertraline can, and often does, contribute to weight gain.
Why Does Zoloft Cause Weight Gain
While scientists and healthcare providers have long known that antidepressants can cause weight gain, there isnt a huge amount of evidence showing why this happens.
Weight gain occurs when people consume more calories from foods and beverages than theyre able to burn through activity.
A variety of environmental factors can affect calorie intake and activity level, including access to certain types of food, large average portions and a lack of opportunities to exercise.
Medical conditions, such as hypothyroidism, Cushing syndrome and polycystic ovary syndrome , may also contribute to weight gain in certain circumstances.
Currently, there doesnt appear to be any evidence to show that sertraline has a negative effect on your metabolism.
In one study from 2009, researchers found that sertraline did not have any significant impact on thyroid function, limiting any potential metabolic effects.
One theory is that antidepressants such as sertraline may stimulate your appetite and make you feel hungrier than normal by affecting your ability to suppress the urge to eat.
This means that if you use sertraline or another antidepressant, you may feel less satisfied after you eat food, causing you to eat larger portions and take fewer steps to control your total calorie intake.
Over time, this increase in calorie intake can lead to weight gain if you dont also increase your activity level.
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