THURSDAY, June 5, 2014 (HealthDay News) -- While it has long
been known that some antidepressants can help spur weight gain, a
new study finds that the actual amount gained is usually small.
"This study was motivated in the first place by the number of patients who have asked me if their medicine is going to make them gain weight," said study co-author Dr. Roy Perlis, director of Massachusetts General Hospital's Center for Experimental Drugs and Diagnostics, in Boston.
"It's the most common question I get when prescribing any medication, frankly," he said. "But most antidepressant studies have been short term, looking at just a few months of treatment. So I wanted to look at it for a longer period of time," Perlis explained.
"I think our findings should be reassuring to patients. Yes, antidepressants can lead in some cases to small amounts of weight gain, that's true. And we need to pay attention to it, and do a much better job of making people aware of the issue," he said.
"But we also found these are drugs that all do their intended job very well, and that the amount of weight gain that they can bring about is very, very modest, and occurs at very similar levels across medications," added Perlis, who is also an associate professor of psychiatry at Harvard Medical School.
The study, funded by the U.S. National Institute of Mental
Health, appears in the June 4 online issue of
According to the researchers, more than 10 percent of Americans
are prescribed antidepressant medications at some point in their
To explore how these drugs might affect weight gain, the
research team conducted an electronic health records analysis to
track weight gain among more than 19,000 adults suffering from
These patients had been treated with at least one of 11
different antidepressants for at least three months between 1990
and 2011. The list included: amitriptyline (Elavil), bupropion
(Wellbutrin), citalopram hydrobromide (Celexa), duloxetine
(Cymbalta), escitalopram oxalate, fluoxetine hydrochloride,
mirtazapine, nortriptyline (Sensoval), paroxetine hydrochloride,
venlafaxine, or sertraline hydrochloride.
Roughly 3,400 additional patients were also included in the
analysis, although none had been diagnosed with depression. All had
been treated for other issues with a range of non-antidepressant
medications, including asthma and anti-obesity prescriptions.
Weight fluctuation among all the patients was followed for one
Perlis and colleagues found that being younger and/or male
increased the risk for gaining weight, as did starting treatment
with a relatively low body mass index (BMI, a measurement based on
weight and height).
When honing in on specific antidepressants, the researchers
found that Celexa seemed to promote more weight gain than other
popular antidepressants. Celexa is from a class of antidepressants
called selective serotonin reuptake inhibitors (SSRIs), which also
includes Paxil, Prozac and Zoloft.
Sensoval, Elavil (which is no longer available in the United
States), and Wellbutrin all prompted "significantly" less weight
gain than Celexa, the research showed.
However, Perlis stressed that the range in weight gain between
the various drugs was very narrow, with very little practical
difference seen in the actual pounds gained by patients on
"Really, these antidepressants are very similar in their potential to cause a small amount of weight gain," he said. "We're talking, on average, of a gain of about one to two pounds over the course of a year. So it's not huge amounts. And I really don't think that our findings would automatically push me to choose one medication over another based on their impact on weight gain. Not unless a patient was very, very concerned about it."
And, Perlis added, antidepressants can at times actually promote
weight loss, particularly among depressed patients who may have
gained some weight prior to beginning treatment.
"So, rather than being scared off because they've gained weight, I would hope people will be reassured that treatment might actually help in that department," he noted. "The aim is to help people be more comfortable getting treatment for these very treatable illnesses, whether with medications or talk therapy or both."
Also touching on the topic of weight gain, another
JAMA Psychiatrystudy looked at how a subgroup of depression
patients appear to be particularly vulnerable to weight gain as a
result of the condition itself, rather than its pharmaceutical
In this case, a team of Swiss researchers, led by Dr. Aurelie
Lasserre from Lausanne University Hospital, focused on patients
diagnosed with a condition referred to as "major depressive
disorder with atypical features." Such patients tend to experience
mood elevations in reaction to positive events.
Such men and women, the investigators found, face a particularly
high risk for developing obesity, and for retaining the extra
weight even after recovering from their depressive condition.
The finding, said Lasserre's team, suggests that doctors should
be particularly careful when prescribing appetite-stimulating
medications to such patients.
For more about
antidepressants, visit the U.S. National Library of Medicine.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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