Citalopram and Weight Gain

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As long as antidepressants have existed, weight gain has been a problem.  Older antidepressant medications such as the tricyclics (TCAs) and monoamine oxidase inhibitors (MAOIs) were able to affect the desired neurotransmitters, but they also affected other neurotransmitters as well, leading to unwanted side effects, such as dry mouth, sleepiness, and weight gain.  When the first selective serotonin reuptake inhibitor (SSRI) – Prozac (generic name fluoextine) – became available in 1988, many hoped that it would solve this problem.

  This new drug class was much more selective, targeting only the receptors for serotonin.  

Unfortunately, while it was true that Prozac did not cause as many problems as its predecessors, it soon became apparent that SSRIs still had the potential to cause weight gain.  In fact, even though Prozac was able to cause a modest amount of weight loss in the short-term, many of the patients who remained on it for longer periods of time eventually regained their lost weight and some patients even gained additional pounds.  Since that time, other SSRIs, including citalopram (brand name Celexa) and paroxetine (brand name Paxil) have joined Prozac, each having varying degrees of risk for causing people to gain weight.

Why Citalopram Causes Weight Gain

It is unclear why citalopram causes weight gain.  However, scientists have speculated that perhaps it somehow influences a person's metabolism or appetite.

  They also believe that people may gain weight when using an antidepressant due to the fact that many people experience loss of appetite and weight loss while they are depressed. Once appetite improves with treatment, it could be possible that what is being perceived as weight gain is simply a return to that person's normal weight.

What You Can Do to Lose Weight on Citalopram?

As with any other type of weight gain, a person's best options for weight loss will be found in making dietary changes, getting regular exercise and perhaps using prescription weight loss drugs.  Two weight loss experts – Elizabeth J. Wurtman, Ph.D. and Nina T. Frusztajer, M.D – also suggest that eating what they call a "therapeutic" amount of carbohydrates could be the key to losing weight when using an antidepressant like citalopram.  In their book, The Serotonin Power Diet: Eat Carbs -- Nature's Own Appetite Suppressant -- to Stop Emotional Overeating and Halt Antidepressant-Associated Weight Gain, they outline an eating plan using carbohydrate consumption to promote the production of serotonin in order to shut off the excessive appetite associated with antidepressant use.

Other Options for Dealing With Weight Gain on Citalopram

An additional option that is available to those who are experiencing problems with weight gain while using citalopram is to change to a different medication.

  Although all antidepressants have the potential to cause weight gain, certain medications are less likely to do so.  For example, a study published in the June 2014 issue of the Journal of the American Medical Association found that, over the course of a one-year period, bupropion, as well as the tricylics nortriptyline and amitriptyline, were associated with less weight gain than citalopram.

Sources:

Blumenthal, Sarah R. et. al..  "An Electronic Health Records Study of Long-Term Weight Gain Following Antidepressant Use."  Journal of the American Medical Association.  Published online ahead of print:  June 4, 2014.  American Medical Association.  Accessed:  July 13, 2014.

Ferguson, James M.  "SSRI Antidepressant Medications: Adverse Effects and Tolerability."  The Primary Care Companion - Journal of Clinical Psychiatry.  3.1 (February 2001):  22-27.

Nihalani, Nikhil.  "Weight Gain, Obesity, and Psychotropic Prescribing."  Journal of Obesity.  2011 (2011).  Accessed:  July 13, 2014.

Weil, Andrew.  "Why Do Antidepressants Cause Weight Gain?Andrew Weil, M.D.  Published:  February 11, 2011.  Weil Lifestyle, LLC.  Accessed:  July 13, 2014.

Wurtman, Judith.  "Reversing Antidepressant Weightgain."  Psychology Today.  Published:  July 26, 2010.  Sussex Publishers, LLC.  Accessed:  July 13, 2014.

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