SSRIs and Weight Gain

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Ever since the first antidepressant was developed, weight gain as a side effect has been a problem.  So, when Prozac (generic name fluoextine), the first of a new class called selective serotonin reuptake inhibitors (SSRIs), came along in 1988, there was a great deal of excitement.  This new antidepressant was selective for serotonin receptors; therefore, it should not be prone to causing many of the dreaded side effects associated with older antidepressants, such as the tricyclics (TCAs) and the monoamine oxidase inhibitors (MAOIs).

Unfortunately, it soon became apparent that, while SSRIs have a much better side effects profile than their predecessors, they are far from being free of problems.  Although many people using Prozac would initially experience weight loss, over time that weight was regained  and sometimes additional pounds were even gained  if they remained on the medication long term.

Since that time, several other SSRI antidepressants have been developed – including Celexa (generic name citalopram), Lexapro (escitalopram), Luvox (fluvoxamine), Paxil (paroxetine), Prozac  (fluoextine) and Zoloft (sertraline) – and they all have varying potentials to cause this dreaded side effect.

Why SSRIs Causes Weight Gain

While the exact reasons that SSRIs cause weight gain are not well understood, it is thought that they somehow affect metabolism or appetite in ways that encourage overeating and subsequent weight gain.

  Some experts have also suggested that the weight gain seen with antidepressants like the SSRIs may be at least partially due to the fact that people tend to lose their desire to eat when depressed.  Once an antidepressant normalizes their mood, appetite returns, leading a person to regain any weight they lost while depressed.

How to Lose Weight on SSRIs

Just like when you gain weight for any other reason, healthy diet, regular exercise and weight loss medications are the best options available for losing weight gained while using SSRIs. 

Although there are no firm recommendations that can be made as to what specific type of diet is best for weight gain associated with antidepressants, two experts – Nina T. Frusztajer, M.D and Elizabeth J. Wurtman, Ph.D.– have suggested that the answer to could lie in eating what they term a "therapeautic" amount of carbohydrates.  To learn more about their ideas, you can read The Serotonin Power Diet: Eat Carbs -- Nature's Own Appetite Suppressant -- to Stop Emotional Overeating and Halt Antidepressant-Associated Weight Gain, in which they discuss a plan for using a high-carbohydrate diet to encourage more serotonin to be produced in order to reduce excessive appetite.

Other Ways to Cope With SSRI Weight Gain

Although all antidepressants may potentially make you weight gain, not all antidepressants affect patients in the same way.

  First of all, certain antidepressants seem to be less prone that others to causing weight gain.  And, even different antidepressants within the SSRIs have a different potential for causing weight gain.  Secondly, different people will respond in different ways to the same antidepressant.  If one antidepressant is proving to be problematic for an individual, switching to a different one could be the answer.

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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