Weight and Mental Health

What Depression Medication Makes You Gain Weight?

Max Carmody, MSc

What are Psychiatric Drugs?

Psychiatric, or psychotropic drugs, are used to treat mental health disorders. They work by adjusting the number of major chemicals in the brain. Decreasing or increasing certain neurotransmitters can help to counter the affects of certain mental health disorders. Neurotransmitters are the messengers that allow your brain to communicate with each other. Psychiatric medication is not a cure, it can only treat mental health disorders, and are sometimes more effective when combined with therapy. 

There are five main types of psychiatric medications. These are anti-anxiety medications, antidepressants, antipsychotics, stimulants, and mood stabilizers. Stimulants help with unorganized behavior, they help with concentration and have a calming effect. Anti-anxiety medications treat a variety of anxiety disorders. Antipsychotics help to manage psychosis, and can sometimes be used for depression. Mood stabilizers help to regulate extreme emotions. In this article we will be talking mostly about anti-depressants, which are used to treat depression. It is important to remember that some of the other classes of drugs, such as antipsychotics, can also be used to treat depression. If you would like to read more about why people gain weight on psych meds in addition to and other than antidepressants, here is an article that I wrote about that.

What are Antidepressants?

As the name suggests, antidepressants are typically used to treat depression. Antidepressants are the third most commonly prescribed drugs in the US, and are taken by 11% of Americans 12 and over. There are multiple types. One type is selective serotonin reuptake inhibitors. These steadily increase the amount of serotonin in your brain. Serotonin is a powerful neurotransmitter that regulates mood, bowel movements, sleep, and more. Another type is selective serotonin reuptake inhibitors. These gradually increase the norepinephrine in your brain. This neurotransmitter makes you feel awake and alert. Then there is bupropion, which promotes important brain activity and can be used to treat seasonal affective disorder, or help people quit smoking. Antidepressants can have many side effects, including weight gain. Some other possible side effects are drowsiness, insomnia, constipation, sexual problems, tremor, or dry mouth.

How Does Depression Medication Lead to Weight Gain?

There are many different possible mechanisms for why antidepressants might lead to weight gain. Some sources estimate that as many as 25% of people on antidepressants experience weight gain. Some medications are more likely to cause weight gain than others. It is not really fully understood why antidepressants lead to weight gain. But it is generally thought that they cause either changes in metabolism, or affect hunger levels. They may even lead to weight loss, rather than weight gain, in some people. 

Antidepressants interfere with serotonin, this is the neurotransmitter that regulates anxiety and mood, and controls appetite. Some of these changes are believed to increase cravings for carbohydrate rich foods, such as bread, pasta, and desserts. Also, when people are depressed, their appetites are generally affected. For some people, this makes them hungrier, while for some, they lose their appetite. It could possibly be the case that when the antidepressants take effect, somebody’s normal appetite returns, and this impacts weight. If you would like to learn more about how depression in general can lead to weight gain, here is an article that I wrote on the topic.

I am not a doctor, so this is not official medical opinion, but I have taken tons of psychiatric drugs, so this is coming from personal experience. I took one drug that caused me to gain as much as 14 pounds in just 2 weeks. I was not experiencing carb cravings, or eating significantly more than before, and I was exercising a lot at the time. So I believe that the metabolism plays a big role. If you would like to learn more about HOW NOT to gain weight on psych meds, here is an article that I wrote.

Which Depression Medications Cause Weight Gain?

Tricylic antidepressants may cause weight gain. Some of these are amitriptyline (Elavil), amoxapine, desipramine (Norpramin), doxepin (Adapin), imipramine (Toranil-PM), nortriptyline (Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil). Monoamine oxidase inhibitors (MAOI’s) were the first class of antidepressant to be developed, and can lead to weight gain. Those that can cause weight gain include: phenelzine (Nardil), isocarboxazid (Marplan), tranylcypromine (Parnate). Of these phenelzine is the most likely to cause weight gain. 

Tetracyclic antidepression medication can cause weight gain, such as Remeron. SSRI paroxetine can cause weight gain (Paxil, or Pexeva). Escitalopram (Lexapro), sertraline (Prozac, Sarafem), and bupropion can all cause weight gain. For treatment resistant depression, some antipsychotics are approved as well. Brexiprazole (Rexulti), and quetiapine (Seroquel) are antipsychotics that can be used for depression, and lead to weight gain.

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