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Do Antidepressants Cause Weight Gain? How to Manage Weight Fluctuations

Last Updated: April 19, 2022

Authored by Sharon Levy, MD, MPH

Reviewed by Michael Espelin APRN

Antidepressants affect all users differently, which is why some report weight gain from them as one of the main antidepressant drugs’ side effects, while others report losing weight on antidepressants. While some might be tempted to find antidepressants that don’t cause weight gain or maybe even cause weight loss, these are rare – antidepressants and weight gain while on them is a more common occurrence, and is one of the adverse reactions more people are worried about. A review published in the Journal of Clinical Psychiatry explored the relationship between several kinds of antidepressants and weight gain. It also focused on antidepressants that cause weight loss and those that don’t cause weight gain at all. This will be discussed further later on in this article.

A woman googles the side effects of the pills.

Reasons Behind Weight Changes When On Antidepressants

When it comes to taking medication for depression, users have to weigh the antidepressant pros and cons. This means carefully examining numerous antidepressant side effects. Out of the many negative effects of use one might experience, body mass changes can be the most difficult to deal with, as there are antidepressants that don’t cause weight gain and antidepressants that cause weight loss. More commonly, though, antidepressants cause gaining some weight. And because body image and mental health tend to be closely linked, changes in body mass can be problematic for these patients.

While the pharmacologic mechanisms or antidepressants’ mechanism of action underlying gaining body mass are currently poorly understood, perhaps one of the main factors for this is genetic predisposition and individual differences. On the bright side, there are several ways to manage gaining body mass, and among them are switching to another antidepressant, increasing physical activities, and getting nutritional assessment and counseling as well as seeking dietary advice.

Do Antidepressants Cause Weight Gain?

So, do antidepressants cause weight gain? It’s true that gaining body mass from antidepressants is a real side effect users can experience, but not all depression medications directly cause users to gain body mass. For example, TCAs have been linked to body mass increases. Thus, many tricyclic antidepressant names are found in the list of antidepressants that cause gaining body mass. However, it isn’t that the medications cause the body to retain more calories and put on extra pounds automatically.

Meanwhile, another consideration is how depression impacts appetite. For many, a lack of appetite (and poor diet, in general) is a symptom of depression. SSRIs may decrease body weight during the initial weeks of treatment, but as they begin to work, the user’s appetite can return, resulting in gaining body mass. Depending on how low the individual’s body mass was to begin with, this could be a good thing. For others, it may be problematic.

How Do Antidepressants Affect Weight?

In some cases, weight gain from antidepressants is a direct side effect of the medication. SSRI and SNRI antidepressants and weight gain as a side effect have been documented through various studies. In fact, it is known that psychotropic drugs often cause weight gain. As mentioned earlier, the pharmacologic mechanisms of antidepressants that affect body mass gain are only partially understood. However, a study suggests that increased energy intake change is linked to antidepressant treatment. In addition, depression often clusters together with poor diet and sedentary lifestyle. And because these drugs interfere with the neurotransmitter serotonin, which also controls appetite, the use of this medication may increase one’s cravings for foods rich in carbohydrates.

Weight Gain Antidepressants List

Body mass gain from antidepressants is more common than dropping pounds. Unsurprisingly, this means many depression medications are associated with increased body mass. It is important that patients understand that body mass gains are not guaranteed, and when medication does result in increased body mass, it tends to be minimal. If their doctor strongly feels medication is needed, they should consider the benefits it could offer them more than the risk of body mass gain.

There are antidepressants that are more likely to cause body mass gain. Among the list of antidepressants, they found that MAOIs (monoamine oxidase inhibitors) and tricyclic antidepressants (TCAs) may be more likely to cause weight gain than SSRIs or selective serotonin reuptake inhibitors. Among several SSRIs, though, it was found that Paroxetine may be more likely to cause body mass gain in the long run. On the other hand, Nefazodone and Bupropion are among the list of antidepressants that don’t cause weight gain. It must be noted, though, that further research or more studies and information are necessary to confirm these impressions. Now, there are also atypical SSRIs or atypical antipsychotic drugs, which are known to cause marked or appreciable weight gain than conventional ones. Atypical antipsychotic drugs include Olanzapine, Risperidone, Clozapine, and Quetiapine.

Do Antidepressants Cause Weight Loss?

Most antidepressants cause mass gain, but losing weight on antidepressants is also possible. Analyses involving adults showed that SSRIs may cause weight loss when used in the short-term, but long-term use may often cause body mass gain. When it comes to losing weight on antidepressants, one drug that can result in body mass loss is Bupropion. It was found that the medication is more effective in achieving weight loss than placebo. However, losing mass while taking depression medication does not mean it is due to the drug itself.

Why Do Antidepressants Cause Weight Loss?

While some people may lose their appetite as part of their depression, others overeat because of their condition. That said, when their depression symptoms begin to lift, they may eat less and choose healthier items, resulting in body mass decrease. Information from a study suggests that a significant number of depressed patients have poor diet and sedentary lifestyle. Depressed individuals are less likely to exercise and more likely to remain at home, sitting or lying down, than those who are not depressed.

A woman with obesity looks at some pills.

Antidepressants That Cause Weight Loss

Whether losing weight on antidepressants is among the negative effects of antidepressants or the positive ones is up for interpretation by each patient. It is possible for the patient to work with their medical doctor to find a medication that is more likely to help them with their body mass goals.

Some Antidepressants That Cause Weight Loss Include:

  • Bupropion: Sold as Wellbutrin, it is an atypical antidepressant that sees some patients lose a noticeable amount of body mass.
  • Fluoxetine: Known by the brand name Prozac, this SSRI tends to result in body mass loss when first taken but can cause gains when the user remains on it long term.
  • Citalopram: Also known as Celexa, this SSRI has been found to make people less hungry and therefore eat less, but they may gain some mass as their appetite returns later on.
  • Duloxetine: Marketed as Cymbalta, this SNRI has been shown to reduce appetite and prevent overeating. However, it was reported that patients on Duloxetine only experience weight loss after short-term treatment, and that longer-term treatment causes modest weight gain.
  • Venlafaxine: Known by the brand name Effexor, it is also an SNRI that has been demonstrated to lower appetite.

It is important that even if someone needs to lose pounds, they should not take antidepressant medications strictly for weight loss. Doing so can result in numerous unintended side effects, as well as misuse of the drugs. In this case, it is critical to find substance abuse treatment to prevent severe health hazards.

Antidepressants That Do Not Cause Weight Changes

Unfortunately, there are no antidepressants that do not cause weight gain or loss. However, there are medications that are known to have minimal impact on body mass, so switching antidepressants after a doctor’s consultation can also be a good option for patients suffering from weight gain.

Patients Are More Likely to Be Able to Use These Drugs With Minimal Mass Gain if They Are Prescribed One of the Following:

  • Sertraline (Zoloft)
  • Amitriptyline (Elavil)
  • Escitalopram (Lexapro)
  • Mirtazapine (Remeron)
  • Paroxetine (Paxil)
  • Nortriptyline (Pamelor)
  • Citalopram (Celexa)
  • Bupropion (Wellbutrin)
  • Venlafaxine (Effexor)
  • Fluoxetine (Prozac)

It is still possible that users will see body mass changes when taking these medications. Patients should stay in contact with their prescribing medical doctor to help manage symptoms of use.

How To Manage Weight Changes Caused By Antidepressants

There is no way to guarantee a person will not gain pounds while taking antidepressants. Just getting older often means putting on pounds, so there is a chance that increased weight will not be related to the medication.

There Are Some Steps That Users Can Take To Avoid Antidepressant Weight Changes:

  • Do a proper weigh-in at a medical doctor’s office prior to starting treatment, so there is an accurate understanding of the starting mass.
  • When feeling a desire to eat, stop to ask if it is from hunger, boredom, or another cause.
  • If noticing an increase in hunger, get the medical doctor to see if this is a result of excess stomach acid being produced. If it is, address this. Excess stomach acid can produce hunger pains.
  • Hydrate more often, as this can help curb sensations of hunger.
  • Start the day with 30 grams or so of carbohydrates as this can spur serotonin production, which helps to curb appetite. Do not combine them with proteins or fat.
  • Exercise often to help burn calories.
  • If all else fails, speak with a health expert and the prescribing doctor about alternative medications and dietary approaches.

Ultimately, the goal of treatment is to become a happier and healthier person. If a patient is gaining a significant amount of weight, they are unlikely to be happy or healthy. Furthermore, drinking while on antidepressants can also become a serious health hazard.

Ending Antidepressants Misuse

Antidepressant misuse and addiction is quite uncommon, but still, there are certain antidepressant classes that are a bit prone to abuse. The most vulnerable population when it comes to this is those with a history of substance abuse. The Drug Abuse Warning Network collected data from US hospitals in 2011, and among the 1,244,872 emergency department visits that involved misuse of over-the-counter medication. 228,366 of these visits resulted from a suicide attempt, of which 20% (or more than 45,000 visits) involved antidepressant overdose. There were a little over 38,000 drug overdose deaths in the USA in 2010, and antidepressants are one of the most common medications involved.

So, when it comes to abuse, misuse, and addiction, the good news is that the majority of individuals on antidepressant treatment are unlikely to misuse the drug. But as previously mentioned, there are certain classes that carry the potential for abuse, with the most vulnerable patients being those with a substance abuse history. Signs that one may be misusing the medication include the presence of aberrant behaviors, and when misuse is suspected, it’s best to refer them to a health expert, specifically an addiction specialist, so a treatment plan that’s most suitable for the individual would be developed and implemented. If someone is experiencing the negative effects of use or has been abusing their medications, stopping antidepressants is critical. However, going cold turkey can be dangerous. Work with a drug rehabilitation center to end use without negative consequences.

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Page Sources

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Published on: October 15th, 2019

Updated on: April 19th, 2022

About Author

Sharon Levy, MD, MPH

After successful graduation from Boston University, MA, Sharon gained a Master’s degree in Public Health. Since then, Sharon devoted herself entirely to the medical niche. Sharon Levy is also a certified addiction recovery coach.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.