Antidepressants and body weight: a comprehensive review

Hi All,

A review on the weight-gaining effects of antidepressants. Real?

[size=140]Antidepressants and body weight: a comprehensive review and meta-analysis[/size]
Journal of Clinical Psychiatry 71 (10), 1259-72 (Oct 2010)

OBJECTIVE: Psychotropic drugs often induce weight gain, leading to discomfort and discontinuation of treatment and, more importantly, increasing the risk of obesity-related illnesses such as diabetes mellitus, hypertension, and coronary heart disease. There is evidence that antidepressant drugs may induce a variable amount of weight gain, but results are sparse and often contradictory.

DATA SOURCES: We performed a literature search using the MEDLINE, ISI Web of Knowledge, and Cochrane research databases for all publications available to January 2009. We used the following keywords: antidepressant, psychotropic drugs, body weight, weight gain, obesity, overweight, adverse event, side effects, SSRIs, tricyclic antidepressants, and the name of each antidepressant active compound together with body weight or other keywords. Studies reporting body weight changes during treatment with different antidepressants were selected for eligibility. Finally, 116 studies were included in the analysis.

DATA EXTRACTION: Weight change mean and standard deviation and size of each group were recorded. Missing means and standard deviations were directly calculated by using information available in the article when possible. Non-placebo-controlled studies were compared to a virtual placebo sample, whose mean and standard deviation were derived by the weighted mean of means and standard deviations of all placebo samples. **Methodological quality of studies, heterogeneity, publication bias, and effect of treatment duration were systematically controlled. **

DATA SYNTHESIS: Quantitative results evidenced that amitriptyline, mirtazapine, and paroxetine were associated with a greater risk of weight gain. In contrast, some weight loss occurs with fluoxetine and bupropion, although the effect of fluoxetine appears to be limited to the acute phase of treatment. Other compounds have no transient or negligible effect on body weight in the short term. However, the effect of each antidepressant may vary greatly depending on an individual’s characteristics and generally became more evident in the long term to a variable degree across compounds.

CONCLUSIONS: Despite the fact that some analyses were done on only a few studies due to the difficulty of finding reliable information in literature, to our knowledge, this is the first comprehensive meta-analysis to allow comparison of different antidepressants as regards their impact on body weight. Data presented may be helpful for a more accurate treatment selection in patients at risk of obesity or related medical illness.

interesting…however I think I’ll stick to staring at the prothiaden for a bit longer

I wonder if they also controlled for “propensity to be a carb-whore” :lol:

what i wonder is is it because appetite increases or does it totally change metabolism?

this is exactly what my neuro said - the tricyclics are the worst for weight gain. some are weight neutral like cymbalta and like all of you have said we are all different some gain weight on one and some do not. i’m still not sure which one i want to try but i keep hearing celexa has least side effects and stuff - my sister knows a pharmacist in CA and he said it’s fairly easy to handle - forgot the word here.

my neuro even said that some of the antiseizure meds put weight on too

chris

I was weaning off nortriptyline because of weight gain, I was only on 30 mg. At 20 mg the rocking came back. At 10 mg the mini spins and motion sickness came back. No thank you! I have revamped my diet and workouts. Man, I forgot how much MAV sucks. Back on 20 now, will be going back to 30. I can complain about nort and weight gain until the cows come home, but the stuff works like a charm for my MAV.

1 Like

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what i wonder is is it because appetite increases or does it totally change metabolism?
chris

— End quote

Chris I’ve often wondered that too, but haven’t found anything in my searching to say either way - Scott, have you come across anything in your literature trawls?

According to my neuro it is a little bit of both. I agree. My appetite has picked up a little, especially sweets, which is the hallmark of tricyclics, but in no way do I eat enough to have gained 35 lbs in six months. Before this med I could have eaten from morning to night and not gained an ounce.

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Scott, have you come across anything in your literature trawls?

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Just had a brief look and couldn’t see anything definitive. Could be there. If you do a Google search a bunch of results come up confirming lowered metabolism but nothing is referenced that I can see. It may be all myth. It sure seemed like my metab was slower but then I was a carb-whore as well. :lol: Hard to say.

ish i wouldn’t mind a bit of weight gain if it got rid of the horrible MaV symptoms but otherwise i wouldn’t want it i’m real vain i guess i hate gaining weight.

chris

Scott I think you mustn’t be searching properly. I Googled ‘insatiable carb whore’ and up came a picture of me with one hand full of Prothiaden and the other plunged deep in a bag of chips. It was very disturbing.

you guys are hilarious - i love chips and fries and cheese - my biggest weaknesses!!

chris