Fat Pharms: Antidepressants and Weight Gain
Up to 25% of people who take antidepressants gain weight. Is there anything you can do about it?
Antidepressants and Weight Gain: What Happens and Why continued...
"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.
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.