Best Antidepressant for Weight Loss?

Best Antidepressant for Weight Loss
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Question: What is the best antidepressant for weight loss?

Answer:  You've worked hard to defeat your depression by attending therapy and taking your antidepressants just like prescribed, only to find that now the numbers on the scale are rapidly moving up and your clothes don't quite fit like they used to.  It doesn't seem fair, does it?  You're feeling better emotionally, but now you don't like the way you look or feel physically.

  You don't want to sacrifice your physical health for your mental health, but what can you do?

The first thing to be aware of is that it's not your fault that you are gaining weight.  Antidepressants cause certain effects on your brain which can increase your appetite and make you feel less satisfied after eating, which can lead you to eat more calories than you need and gain weight.

But, what can you do about this?  The good news is that certain antidepressants can actually cause a small amount of weight loss.  There are also others which, while they don't cause weight loss, don't tend to cause you to gain either, which can be helpful when you are attempting to take those excess pounds back off through diet and exercise.

The first thing you want to do before starting a diet and exercise program is to see your doctor for a checkup.  During your visit, speak with her about whether you might be able to change to a different medication which might enhance, or at the very least, not hinder your efforts.

For the most part, the selective serotonin reuptake inhibitors -- fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa) and escitalopram (Lexapro) -- do not affect weight, although fluoxetine may cause some weight loss and paroxetine may cause weight gain.

Venlafaxine (Effexor), duloxetine (Cymbalta), trazodone (Desyrel), nefazodone (Serzone),  desvenlafaxine (Pristiq) and vilazodone (Viibryd) also do not tend to affect weight in any significant way.

The best antidepressant for weight loss, however, may be bupropion (Wellbutrin).  Bupropion is known to cause significant weight loss (defined as weight loss greater than 5 pounds) in 28% of those who take it, perhaps because it reduces appetite.  In fact, in 2014, the U.S. Food and Drug Administration gave its approval for a new prescription weight loss drug called Contrave, which combines bupropion with an anti-addiction drug called naltrexone.

Bupropion may not be appropriate for all people though.  In particular, you should not use it if you have a history of seizures or an eating disorder like anorexia or bulimia, which could put you at greater risk for having a seizure while using it.  Like all antidepressants, bupropion also carries a black box warning regarding its potential for increased risk of suicidal thoughts and actions in children, teens and young adults during the early stages of treatment.

  It should also be used with caution by the elderly and those with kidney or liver disease, bipolar disorder, drug addiction or diabetes.  Your doctor can provide you with more information about whether it may be right for you.

Sources:

"Contrave, Newest Weight Loss Option:  FAQ."   WebMD.  WebMD, LLC.  Reviewed by: Arefa Cassoobhoy, MD, MPH on September 11, 2014.  Accessed:  January 5, 2016.

Moore, David P. and James W. Jefferson. Handbook of Medical Psychiatry. 2nd ed. Philadelphia: Mosby, 2004.

"Psychiatric Medications:  Bupropion."  Stanford Medicine | What Meds.  Stanford School of Medicine.  Accessed:  January 5, 2016.

Vieweg, W. Victor R. et. al. "Psychotropic Drug Considerations in Depressed Patients with Metabolic Disturbances." The American Journal of Medicine 121.8 (2008) : 647-55.

Wurtman, Judith J.  "Who's Helping You Lose Weight From Your Antidepressant?"  Psychology Today.  Sussex Publishers, LLC.  Published May 14, 2015.  Accessed:  January 5, 2016.

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