If you're scuffling with depression, an important query about taking an antidepressant is whether or not it can work. But one other query you'll have is whether or not it can cause weight gain.
“It's important to recognize that weight gain is a major reason why some people decide to stop antidepressants, even if they're doing well otherwise,” says Dr. Roy Perles, Massachusetts General Hospital. I'm Associate Chief of Psychological Research. “It's also one of the reasons people are reluctant to start them in the first place, even if they're quite depressed or anxious.”
What did the study find?
Published in July 2024. History of Internal Medicinelatest study obtained data from greater than 183,000 people between the ages of 20 and 80. Their average age was 48, and 65% were women. Most were obese or obese at the beginning of the study.
The researchers analyzed the participants' electronic health records and body mass index. People measured weight gain or loss at regular intervals — six, 12, and 24 months — after they first began taking the antidepressant.
The study compared the weight-related effects of sertraline (Zoloft) to seven other antidepressant medications:
- Escitalopram (Lexapro)
- paroxetine (Paxil)
- Duloxetine (Cymbalta)
- citalopram (Celexa)
- Fluoxetine (Prozac)
- Venlafaxine (Effexor)
- bupropion (Wellbutrin).
What did the research find?
Antidepressants caused the next average weight gain:
- sertraline: about 0.5 kilos in six months; 3.2 kilos in 24 months
- escitalopram: 1.4 kilos in six months; 3.6 kilos in 24 months
- Paroxetine: 1.4 kilos in six months; 2.9 kilos at 24 months
- duloxetine: 1.2 kilos in six months; 1.7 kilos in 24 months.
The study found that citalopram, fluoxetine, and venlafaxine were no roughly more likely to cause weight gain than Zoloft. And only bupropion was related to a small amount of weight reduction — 0.25-pound — at six months. But this trend reversed at 24 months, when bupropion led to a median weight gain of 1.2 kilos.
What does the study tell us?
“Weight gain is common among antidepressant users, even if the average gain is modest,” says Dr. Perles, who was not involved in the brand new study. This suggests similar results to other studies of antidepressants, including Research He published it with colleagues a decade ago.
“While the difference in weight for certain antidepressants is small, there are certainly some – such as bupropion – that cause weight loss,” he notes.
It's vital to take note that the study indicates average weight gain. Many people taking antidepressants don't gain weight and others may gain weight. “Still, having average values ​​to work with — and seeing that these averages are consistent with previous studies — at least gives us a sense of what people can expect,” he said. say
“One caveat is that some people lose weight as a result of depression, which can affect appetite,” he adds, “so what we're seeing may be that those people regain weight.” are doing that might have been lost with improvement in depression or anxiety.”
What were the extra limitations of the study?
Other limitations could have shaped the outcomes. The study was observational, meaning it couldn't prove that antidepressants caused weight changes, only that they were related to them. It wasn't a randomized, controlled trial — considered the gold standard in research — and didn't compare participants taking antidepressants to a control group who weren't taking the drugs.
Additionally, six months after the study began, just one in three participants was still taking their initially prescribed medication. This makes it difficult to link any changes in weight to a particular drug.
“As with any study that's not randomized, we don't know if the differences between the drugs may reflect other differences in who gets the drugs,” says Dr. Perles. are “But, in situations where a randomized trial is impractical, health records can be a helpful way to try to study side effects and produce at least a partial answer to these important questions.”
What else should you think about?
Another thing to contemplate, when you're taking an antidepressant, is what sort of uncomfortable side effects you're willing to tolerate in exchange for its mood-smoothing advantages.
“The best way to manage side effects is to anticipate them—have an open conversation with your doctor about the potential risks and how we'll manage them if they occur,” says Dr. Perles.
What are you able to consult with your doctor?
If weight gain is a selected concern for you, you could also consider non-drug treatments for depression. These include:
- Cognitive behavioral therapy (CBT), a variety of psychotherapy that teaches people to change into aware of their pondering patterns and adjust them to reframe their pondering during stressful moments.
- Repetitive transcranial magnetic stimulation (rTMS), a brain stimulation therapy that's non-invasive. It uses an electromagnetic coil placed on the scalp to deliver magnetic pulses that stimulate nerve cells in areas of the brain involved in depression.
“We know that certain types of talk therapies, particularly cognitive-behavioral therapy, can be very effective in treating depression and anxiety disorders,” says Dr. Perles. “Whether people choose talk therapy or antidepressants can depend on their preference. It's important to have multiple options.”