Ssri that don't cause weight gain
Antidepressants cause minimal weight gain
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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 Hospital’s Center for Experimental Drugs and Diagnostics, included more than 19,000 men and women and lasted for a year.
Using electronic health records, the researchers identified men and women who took an antidepressant for at least three months. Medications used included amitriptyline (Elavil), bupropion (Wellbutrin), citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), mirtazapine (Remeron), nortriptyline (Pamelor), paroxetine (Paxil), venlafaxine (Effexor), or sertraline (Zoloft). They also identified another 3,400 people who took some other type of medication for a non-depression ailment. Each person’s weight was checked every three months 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.
Bupropion was associated with the least amount of weight gain, close to none. Two others that also appeared to have less weight gain were amitriptyline and nortriptyline.
Amitriptyline and nortriptyline are older drugs. Because newer drugs tend to have fewer side effects, those two aren’t prescribed as frequently. At the other end of the spectrum, citalopram caused the most weight gain. Even so, the differences between the drugs were small. The results of the study were published in JAMA Psychiatry.
Not everyone taking antidepressants gained weight. Some actually lost a few pounds.
Tip for choosing an antidepressant
The results of this study indicate that worries about weight gain shouldn’t 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. It’s 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.
- Decreased energy level. 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, don’t expect to see a major improvement right away. It often takes 6 to 8 weeks to see a response to an antidepressant. And don’t give up if the first one doesn’t work. Trying a different one may do the trick.
Another option to consider is psychotherapy, especially if the first drug doesn’t work. People who do not respond to the first antidepressant can often do as well with talk therapy as they would with another drug.
Keep in mind that a small number of people have a condition called atypical major depression. Instead of the more usual problems of decreased appetite and difficulty sleeping, their depression causes an increased appetite and sleeping too much. This leads to weight gain regardless of drug therapy. For them, it’s probably best to stay away from an antidepressant that causes even more weight gain.
Weight Gain and Antidepressants (Including SSRIs)
More than 1 in 10 Americans take antidepressants to treat depression. For the most part, these medications get the job done. Your health care provider may need to tweak your dosage or switch you to a different kind to find the best fit, but most people notice an improvement in 6 weeks or so.
Like every other medication, antidepressants have side effects that affect some, but not all people. One of the most notable is weight gain.
To be fair, weight gain or loss can be a part of any mood disorder, whether you’re taking an antidepressant or not.
Some people lose their appetite and lose weight; others crave carbs, eat more, exercise less, and gain weight.
So what can you expect and what are your options?
Effects on Weight Can Vary
If depression dimmed your appetite, weight gain may actually be a good thing.
“I’ve had some individuals feel so much better on medication that they are willing to work toward ways to lose weight and eat healthier since they are feeling better,” says Uma Naidoo, MD, a Harvard-trained psychiatrist, professional chef, nutritional biologist, and author of This Is Your Brain on Food. “If they had been losing weight due to a loss of appetite, it may be a relief to be eating better.”
If depression revved up your appetite, the extra pounds may put your physical health at risk. But depression is a serious medical condition that needs treatment.
“Ultimately the goal of antidepressant treatment for most is to achieve remission of troubling depressive symptoms and recover to a life that feels more connected and hopeful,” says Kelly N.
Gable, PharmD, BCPP, professor and director of Well-being and Resilience at SIUE School of Pharmacy and Psychiatric Pharmacist at Family Care Health Centers in St. Louis, MO. “If antidepressant treatment is part of that journey, we must always ensure that the side effects do not overshadow the benefits along the way.”
Does Weight Gain Happen With All Antidepressants?
No. And it doesn’t happen to everyone.
“In general, weight gain is a possible side effect of most antidepressants, such as Zoloft, Prozac or Celexa, but each person will react to antidepressants differently,” Naidoo says.
How much weight gain is typical? A quarter of those who take antidepressants gain 10 pounds or more, Naidoo estimates.
Is Weight Gain More Likely With Some Types of Antidepressants Than Others?
Yes. Antidepressants are grouped based on how they interact with certain chemical receptors in your brain. The most often prescribed types are:
- Selective serotonin reuptake inhibitors (SSRIs) include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil), paroxetine mesylate (Pexeva), and sertraline (Zoloft).
They increase the levels of serotonin in your brain. - Serotonin and norepinephrine reuptake inhibitors (SNRIs) change the way the neurotransmitters in your brain talk to your brain cells. Examples include desvenlafaxine (Pristiq), duloxetine (Cymbalta), levomilnacipran (Fetzima), and venlafaxine (Effexor XR).
- Tricyclic antidepressants increase the amount of serotonin and norepinephrine in your brain and include desipramine (Norpramin), imipramine (Tofranil), and nortriptyline (Pamelor).
- Atypical antidepressants, such as bupropion (Wellbutrin) and mirtazapine (Remeron), don’t fit into the groups above, but, like the others, they alter your brain chemistry to treat depression.
“SSRIs as a class are all fairly comparable with regard to weight gain risk, with paroxetine [Paxil] being the most likely in this group,” Gable says. “When comparing all antidepressants, bupropion [Wellbutrin] is the least likely to cause weight gain and, in most cases, will be weight neutral or cause weight loss over time.
Alternatively, mirtazapine [Remeron] is most widely implicated in weight gain as a side effect.”
What Are the Potential Side Effects of Weight Gain From Antidepressants?
Five pounds or less won’t have a big effect on your overall health. But 10 pounds or more can change your cholesterol and blood pressure, and raise your risk for diabetes.
That said, it’s important to keep your goals in mind. Depression is a serious condition. It’s the leading cause of disability worldwide, affecting work, relationships, and even heart health, Gable notes.
“Any weight gain must be weighed against the negative possible outcomes of untreated depression,” Gable says.
If I Gain Weight, How Should I Manage It?
If you notice weight gain, or any side effects from antidepressants that concern you, talk to your health care provider first. It could be the antidepressants, increased appetite as depression lifts, or something else.
“It’s important when taking any medication, and in particular antidepressants, to be closely followed by your mental health provider, as well as a primary care provider,” Naidoo says.
“They will have the ability and knowledge to identify risk factors and screen for any conditions for which one may be at risk.”
If there are other drawbacks to your current medication, you might be better suited to a different antidepressant.
“For some individuals who experience significant weight gain, or find weight gain to be troublesome, switching antidepressants may be an option,” Gable says.
For instance, she says that if you’re taking an SSRI, “switching to fluoxetine [Prozac] could be helpful. Considering a trial of bupropion [Wellbutrin] may also be an option. But this must always be balanced with the positive side effects that may have occurred with the antidepressant in question, as not all antidepressants will have the same positive impact on each individual person. If you find an antidepressant that works well for you, sticking with that treatment and trying some weight loss strategies may be the best path to take.”
Can I Prevent Weight Gain While on Antidepressants?
Yes, the same way you prevent weight gain in general: With healthy food, exercise, sleep, and stress management.
“Optimizing your nutritional intake with plant-predominant whole foods that are nutrient-dense and rich in fiber and adding in a physical activity routine that brings joy can be very helpful in maintaining a healthy weight while taking an antidepressant,” Naidoo says.
Remember to rule out other factors, like thyroid hormone changes, menstrual cycle changes, digestive issues, or drinking more alcohol.
Is it true that antidepressants make you fat?
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Author: Alexandra Kurchatova
July 15, 2021
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Weight gain is a possible side effect of many antidepressants, but not all. In addition, each person reacts differently to antidepressants: some people gain weight, while others do not.
Why people get fat because of antidepressants is still not clear. Some drugs are known to be more likely to cause weight gain than others.
These include the following:
- Most commonly prescribed selective serotonin reuptake inhibitors (SSRIs). They have few side effects, but some drugs, such as paroxetine, can cause weight gain.
- Tricyclic and tetracyclic antidepressants such as amitriptyline, imipramine and doxepin. They are used less often than SSRIs because they have more side effects. Among them are constipation, drowsiness, weight gain.
- Monoamine oxidase inhibitors such as phenelzine (Nardil). They have many side effects, including weight gain. Those who take them have to avoid certain drugs and foods, such as cheeses, sausages, soy, and other foods high in tyramine and tyrosine.
- Atypical antidepressants are drugs that are not classified in other groups. One of them, mirtazapine (Remeron), increases appetite and promotes weight gain.
Not all drugs in the categories listed cause weight gain. For example, bupropion, an atypical antidepressant, does not have this side effect.
Weight is affected not only by antidepressants, but also by a person's condition.
Symptoms of depression vary from person to person. For example, someone overeats, so they gain weight. Someone, on the contrary, does not want to eat - and he loses weight. And then he starts taking antidepressants, because of this, his mood improves, appetite appears, which leads to natural weight gain.
Sometimes weight gain has nothing to do with depression or medication. Adults tend to get better with age.
People with depression often change their lifestyle. I lose strength for sports, walks, it’s hard to even get myself out of bed. If there are fewer activities and more food, then the weight may increase.
Because a person consumes more calories than they burn during the day.
It is perfectly normal to be nervous before taking a new drug, especially if it is an antidepressant that affects the biochemical processes of the brain. Discuss your experiences with the therapist or psychiatrist from whom you received the prescription. Perhaps together you will select a drug that does not have such a side effect.
But be prepared that this is not always possible. The benefits of taking the right antidepressant, that is, the cure for depression, are more important than temporary weight gain. If you have the strength, weight can be controlled by a balanced diet and increased physical activity. Even the simplest types of exercise will do: walking, running, cycling.
First, don't blame yourself.
Second, if you've gained weight since you started taking antidepressants, don't stop treatment.
Watch your body for a couple of weeks: the body needs to get used to the drug, and then the side effects will pass. If you are concerned about changes in the body, the side effects should be discussed with a therapist or psychiatrist. He can change the dosage or choose another drug. Physical activity and a balanced diet will also help here.
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Study: antidepressants lead to weight gain
May 25, 2018, 2:58 pm
Widespread use of antidepressants may contribute to rising rates of obesity in developed countries.
The risk of becoming overweight in those who take drugs to combat depression for a long time is 21% higher. This conclusion was reached by doctors at King's College London. The work was published in the medical journal The BMJ. This is reported by The Independent.
"The widespread use of antidepressants may be one of the reasons for the long-term increase in the weight of the world's population," said one of the co-authors of the work, Martin Gulliford.
The study showed that the risk of weight gain increased after 2-3 years of taking antidepressants. The risk of developing obesity and the appearance of extra pounds in such patients was 29% higher.
As noted by the authors, the findings suggest that antidepressants should be used less often in the treatment of mild forms of depression. In such cases, cognitive behavioral therapy and exercise should be a priority.
The study was based on data from 300,000 British patients between 2004 and 2014. Information included data on patients taking antidepressants and their body mass indexes (BMI).
The researchers adjusted for other factors that could influence weight, such as age, chronic illness, smoking, and other medications.
Weight gain of 5% of body weight or more within a year was 8.1% among patients not taking antidepressants. Among those who took medication to combat depression, the figure was 11.2%. After 3 years of taking antidepressants, the risk of gaining 5% of body weight per year increased to 46%. The study showed that the risk of becoming overweight is highest in the second and third years of taking antidepressants. In the next 6 years, the risk also remains elevated.
Researchers analyzed the effects of 12 common types of antidepressants on body weight. Thus, the drug mirtazapine (another name is remeron) in half of the cases led to an increase in the weight of patients by at least 5% of the body weight before taking the drugs. The drug citalopram increased the risk of weight gain by 26%.
According to the Organization for Economic Co-operation and Development (OECD), the majority of antidepressant users are in Iceland.
