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Fat Pharms: Antidepressants and Weight Gain

Up to 25% of people who take antidepressants gain weight. Is there anything you can do about it?

Weight Gain and Antidepressants: Switching Drugs Can Help

While experts may not be certain about why antidepressants cause weight gain, they do know that switching drugs may make a difference.

Some antidepressants may be less likely to affect weight. Effexor and Serzone generally do not cause weight gain, while Wellbutrin can cause weight loss.

Sometimes switching within the same class of drugs can make a huge difference.

"Right now, the SSRI Paxil is the worst offender -- the antidepressant most likely to cause weight gain, while another SSRI, Zoloft, is the least likely, so that's a switch that can sometimes make a big difference for some people," says Sussman.

The downside to switching drugs: Sussman says not every drug works equally well to control symptoms in all people.

"The neurochemistry involved in depression is extremely complex and slightly different for everybody, so while switching drugs may help with the weight gain, you might forfeit some control over depression symptoms," says Sussman. 

So far, no drugs (including weight loss drugs) have been sufficiently tested to be approved for use in managing weight gain from psychiatric medications. The authors of the Cleveland Clinic review report that using regular doses of antidepressants with low doses of certain stimulant drugs or seizure medications may help mitigate some weight gain, while adding low doses of Wellbutrin or naltrexone (a drug used in the treatment of alcoholism) to an antidepressant regimen might also help.

If you are taking antidepressants, you should never use any weight loss medication without the consent of your physician, cautions Fincham. "In my opinion I also do not see the herbal weight loss products as a viable option." he says.

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.

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