Weight gain is a common side effect reported by patients who start taking medication for depression. This weight gain can be difficult to interpret because a common symptom of depression is decreased appetite and weight loss. So treating depression may lead to weight gain simply because appetite is returning to normal. However, some medications appear to cause this effect more often than others and one most commonly causes a small degree of weight loss. Exercise is also a highly effective treatment for depression that is excellent for weight control.
Antidepressants and Weight Gain
Because of the difficulties in distinguishing between normal and abnormal weight gain in patients taking antidepressants, every medication ever used to treat depression has been associated with weight gain in at least one study, states "Current Diagnosis & Treatment: Psychiatry." However, most antidepressants have also been associated with weight loss, to one degree or another. Determining which antidepressants are least likely to cause weight gain is a question of looking at the balance of these two results and inevitably involves a certain amount of judgment. Different doctors may have different opinions as to which medications are best for preventing weight gain.
A review of antidepressants and weight gain published in the July 2003 issue of the "Cleveland Clinic Journal of Medicine" concluded that antidepressants most likely to cause weight gain include monoamine oxidase inhibitors, such as phenelzine, or Nardil; isocarboxazid, or Marplan; and tranylcypromine, or Parnate, and tricyclic antidepressants, which include such medications as amitriptyline, or Elavil; dibenzepin, or Noveril; and demexiptiline, or Deparon.
The review also concluded that selective serotonin reuptake inhibitors, or SSRIs, which include such medications as fluoxetine, or Prozac; paroxetine, or Paxil; and sertraline, or Zoloft, are unlikely to cause weight gain in the short term---less than six months---but might cause weight gain over longer periods. Most of the SSRIs are more or less equivalent in this respect, but paroxetine may be somewhat more likely to cause weight gain than others.
Buproprion
Like all antidepressants, buproprion, trade name Wellbutrin, has been associated with weight gain in some studies. Unique among the antidepressants available in the U.S., however, it has been associated with a small weight loss far more often than with weight gain. In a typical result published in the April 1999 edition of the journal "Clinical Therapeutics," patients treated for depression with buproprion lost an average of about 2.5 pounds over the first 12 weeks of treatment. Buproprion is not an appropriate medication for everyone, however, since it can bring on seizures in patients already prone to them. It also, unlike the SSRIs, has little effect on the anxiety that often occurs along with depression, notes "Current Diagnosis & Treatment: Psychiatry."
Exercise
While not a medication, exercise is an effective antidepressant. In a study published in the December 2005 issue of "Medicine & Science in Sports & Exercise," a single exercise session was found to significantly improve mood in patients with major depression. These results are consistent with other studies that have found long-term exercise---usually for longer than six weeks---to be highly effective against depression. While it's unrealistic to expect severely depressed people to begin an exercise program, once their mood improves in response to medication, exercise can help them avoid any associated weight gain and possibly allow them to reduce the dose, reports "Current Diagnosis & Treatment: Psychiatry."
References
- "Current Diagnosis & Treatment: Psychiatry, Second Edition"; Michael H. Ebert et al.; 2008
- "Cleveland Clinic Journal of Medicine"; Antidepressants and Weight Gain; R. Deshmukh and K. Franco; July 2003
- "Clinical Therapeutics"; A Placebo-Controlled Comparison of the Antidepressant Efficacy and Effects on Sexual Functioning of Sustained-Release Bupropion and Sertraline"; H Croft et al.; April 1999
- "Medicine & Science in Sports & Exercise"; Effects of Acute Exercise on Mood and Well-Being in Patients With Major Depressive Disorder"; December 2005
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