Before prescribing an antidepressant to help you manage the symptoms of depression, your doctor will discuss with you the potential side effects of the medication. Because your doctor hopes for a successful treatment outcome, she will likely discuss a well-known reason that many patients are noncompliant with their antidepressant regimen: weight gain.
History
Antidepressant therapy has been used long enough and often enough that medical experts have been able to make a direct correlation between the therapy and the potential for weight gain in certain patients. Speculations regarding the correlations are not always well understood, but the fact remains that the weight gain associated with antidepressants is a direct reason why patients stop taking, or refuse to begin taking, these types of medications. If you are concerned about gaining weight -- especially if you have other conditions for which weight gain is a potential complication - -be forthright with your doctor. There are several types of antidepressants, and some are more likely than others to cause weight gain.
Types
According to Mayo Clinic psychiatrist Dr. Daniel Hall-Flavin, certain types of antidepressantsare more likely than others to cause the unwanted side effect of weight gain. These medications include monoamine oxidase inhibitors, or MAOIs, one example of which is phenelzine, also called Nardil. Amitriptyline, a tricyclic antidepressant, is associated with weight gain, as are others in this class of medications.
Dr. Charles Raison, Emory University Medical School psychiatrist, states that paroxetine -- or Paxil - -a serotonin reuptake inhibitor, or SSRI, is associated with weight gain. And as of Aug. 10, 2010, there is a newer antidepressant available called mirtazapine, or Remeron, that is associated with a "significant" gain in weight.
Expert Insight
The exact reasons for weight gain while taking antidepressants are numerous and dependent upon the particular medication. According to the "Cleveland Clinic Journal of Medicine," those who take tricyclic antidepressants experience increased appetite and cravings for carbohydrates, both of which are logically associated with weight gain. Weight gain from the use of MAOIs is most likely the result of the pharmacological action of the drug in the brain. In addition, SSRIs can also cause an increase in appetite and carbohydrate cravings.
Considerations
Some antidepressant medications are less likely to cause weight gain than others. Hall-Flavin states that these medications include bupropion, or Wellbutrin, and venlafaxine, also known as Effexor. And although SSRIs are a class of antidepressant drugs linked to increased pounds, according to the "Cleveland Clinic Journal of Medicine", this weight gain is more likely to occur with long-term use of these medications. This side effect is less likely to occur in patients taking these medications for six months or less. In fact, SSRIs may actually cause you to lose weight over the first weeks or months of treatment.
Potential Misconceptions
If you experience weight gain after beginning antidepressant therapy, the extra pounds may not be a direct cause of the pharmacological action of your medication. For example, overeating and lack of appetite are symptoms of depression. Report weight gain to your doctor, as overeating may be a sign that your antidepressant is not working. Your doctor may recommend increasing the dosage of the medication or trying a different antidepressant altogether. Conversely, because a decrease in - -or absence of -- appetite is an associated symptom of depression, your weight gain may simply be an important indication that your antidepressant is, in fact, working.
Whatever the direct cause, if you experience weight gain after starting an antidepressant medication regimen -- even if the gain is a desired outcome of therapy -- be sure to report your findings to your doctor. Good communication between the two of you will allow for important tracking of weight gained, as well as possible intervention before that gain puts you at risk for other medical conditions.
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