The clinical association between weight gain and selective serotonin re-uptake inhibitors or SSRIs for people being treated for clinical depression has been well documented. According to the literature, weight gain seems to be one of the most undesirable side effects of the medications. Physicians fear it may possibly derail some people from receiving necessary treatment or, alternatively, increase their risk for comorbidities like diabetes, high blood pressure and hyperlipidemia if the weight gain is substantial.
Function of SSRIs
SSRIs are common medications prescribed to people struggling with depression. Drug names such as Prozac, Zoloft, Luvox, Paxil, Celexa and Levapro are SSRI medications. Mayo Clinic experts report that it is not entirely clear how SSRIs work. They suspect that certain brain chemicals like seratonin are not operating properly in people with depression and the medications make the seratonin more available for the brain. This improved availability then improves the function or quality of the nerve impulse transmission and consequently improves your mood.
Size of Weight Gain
Michelson, et al, in the American Journal of Psychiatry, studied the effects of the medication Prozac over 12 months of therapy. They found that the first four weeks on the medication actually resulted in a 0.4 kg weight loss. In fact, short term use, considered three to six months of therapy, demonstrated only modest weight gains of a few pounds. Statistically significant weight loss, considered a 7 percent weight gain, was observed in 18 percent of the population.
Another six-month, double-blind study in the Journal of Clinical Psychiatry compared the effects of Prozac, Paxil and Zoloft and their weight change effects. They found that 25.5 percent of patients on Paxil, 4.2 percent of patients on Zoloft and 6.8 percent of patients on Prozac experienced a 7 percent weight gain or greater during the course of the study.
Considerations
Over the short term, SSRIs may produce a slight weight loss. This may be due to the continued appetite suppression from the clinical depression or from the potential pharmaceutical side effect of nausea. Over time, there is discussion about whether the weight gain is because of improved appetite due to changes in the body or even a resolution of the depression resulting in a better appetite. One study by Bouwer and Harvey suggests that Celexa can cause significant weight gain because of increased carbohydrate cravings.
Significance
According to Sansone, et al, weight gain can be an acceptable side effect. He found that people were willing to gain as much as 5.37 pounds for a non-life threatening psychiatric condition and 12.7 pounds for a life threatening one. In addition, for many people with depression who have been suffering from weight loss and poor appetite, weight gain is a welcome side effect.
Prevention/Solution
Speak to your physician if you are concerned about the weight gain side effects. She may be able to find success for you with another medication. In addition, working with your physician with short and long term goals in mind may help to regulate any concerns. Avoiding treatment because of undesired side effects appears to be a needless concern.
References
- "Changes in weight during a 1 year trial of Fluoxetine"; American Journal of Psychiatry; Michelson, David, et al; 1999.
- "Fluoxetine vs. sertraline and paroxetine in major depression: Changes in weight with long term treatment"; Journal of Clinical Psychiatry; Fava, M, et al; 2000
- "Phasic craving for carbohydrate observed with citalopram"; International Clinical Psychopharmacology; Bower, et al; 1996
- "Patient attitudes toward weight gain with medications"; Gen Hosp Psychiatry; Sansone, R.A.; 2004
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