Depending on the duration of treatment, the dose and the molecule used, the weight gain can be more or less significant: from a few kilos to 10 to 20 kg depending on the person.
The catch antidepressants can be scary because of risk of weight gain. At least, that’s what we often hear about these drugs. In reality “there are few studies randomized against placebo or against a reference molecule, double-blind, which can allow us to explain in a clear-cut manner the link between antidepressants and weight gain” underlines Professor Bruno Fève, endocrinologist in Paris. Indeed, in addition to the antidepressantsoften used to treat depressionsyndromes bipolar or unipolar, antipsychotics or neuroleptics can also make you gain weight the patients. “In the experience of psychiatrists and endocrinologists, we have the impression that some neuroleptics stimulate the appetite more that antidepressants in certain treated people and by this means promote weight gain” even reports the specialist.
Some stimulate the appetite more than others
It exists schematically 3 main families of antidepressants commonly prescribed for depression:
- serotonin reuptake inhibitors (SRIs) such as Prozac® (fluoxetine), Deroxat® (paroxetine). “For the latter, opinions are quite opposite: at very high doses, some specialists say they cause weight gain; others lose weight.”
- serotonin norepinephrine reuptake inhibitors (SNRIs) such as Effexor® (venlafaxine). “It is more observed a own appetite stimulation effect with these therapies, outside of the classic mechanism for exiting the melancholic episode” (eating again when you feel better).
- tricyclic antidepressants (old generation, used most often in 2nd or 3rd line) like the Laroxyl® (amitriptyline)… have clearly an effect on weight gain.
Laroxyl “clearly has an effect on weight gain”
It should be noted that weight gain linked to antidepressants is very dose-dependent. The longer you take them, in larger quantities, the more likely you are to gain weight.
How many extra kilos?
Depending on the duration of treatment, the dose and the molecule used, weight gain can be more or less significant: from a few kilos to 10 to 20 kg depending on the person, and can then promote the development of pathologies: glucose intolerance, even diabetes or dyslipidemia depending on the genetic background. “He is difficult to give a weight gain scale because this can be minimal or vice versa. These patients should be followed by different doctors specializing in the problem” he notes.
The risk of weight gain peaks after two to three years of use.
The METADAP cohort, carried out in France and coordinated by Professor Emmanuelle Corruble, made it possible to follow depressed patients treated with antidepressants over 6 months and to monitor the occurrence of metabolic syndrome. “In 650 patients, we observed that they tended to develop metabolic disorders (weight gain, tension, glucose intolerance, dyslipidemia, etc.) more than in the general population. The causes of these disorders may be linked to genetic determinants and/or environmental factors such as diet, lifestyle, work, surroundings.” he explained. In 2018, English researchers from King’s College London showed that patients who were prescribedone of the 12 most commonly used antidepressants (of which mirtazapine (Norset®), duloxetine (Cymbalta®), sertraline (Zoloft®), venlafaxine (Effexor®), citalopram (Seropram®Celexa), fluoxetine (Prozac®),
escitalopram (Seroplex®), amitriptyline (Laroxyl®), paroxetine (Deroxat®Seroxat®)), were 21% more likely to experience an episode of weight gain than those who did not take these medications. THE risk of weight gain peaked after two to three years of use keep on going. For patients classified as having “normal” weight the risk of moving into the “overweight” or “obese” category increased by 29% compared to those who do not take antidepressants.
Thanks to Professor Bruno Fève, endocrinologist at Saint-Antoine hospital, Paris