By Maureen Salamon, Executive Editor, Harvard Women’s Health Watch
Reviewed by Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing
Harvard Health Publishing
– Date: August 2, 2024
– Source: Harvard Health Publishing
Introduction
For those struggling with depression, the efficacy of antidepressants is paramount. However, concerns about potential side effects, including weight gain, can deter individuals from starting or continuing treatment. A recent study provides insights into the average weight gain associated with eight commonly prescribed antidepressants, offering a clearer picture for patients and healthcare providers.
Study Overview
Published in the Annals of Internal Medicine in July 2024, the study involved over 183,000 participants aged 20 to 80, with an average age of 48 and 65% being women. Most participants were overweight or obese at the study’s outset. Researchers analyzed electronic health records and body mass index data, tracking weight changes at six, 12, and 24 months after initiating antidepressant treatment.
Antidepressants and Weight Gain
The study compared the weight-related effects of sertraline (Zoloft) with seven other antidepressants: escitalopram (Lexapro), paroxetine (Paxil), duloxetine (Cymbalta), citalopram (Celexa), fluoxetine (Prozac), venlafaxine (Effexor), and bupropion (Wellbutrin).
Key Findings
– Sertraline (Zoloft): Weight gain of nearly 0.5 pounds at six months, increasing to 3.2 pounds at 24 months.
– Escitalopram (Lexapro): Weight gain of 1.4 pounds at six months, rising to 3.6 pounds at 24 months.
– Paroxetine (Paxil): Weight gain of 1.4 pounds at six months, reaching 2.9 pounds at 24 months.
– Duloxetine (Cymbalta): Weight gain of 1.2 pounds at six months, increasing to 1.7 pounds at 24 months.
– Citalopram (Celexa), Fluoxetine (Prozac), Venlafaxine (Effexor): No significant difference in weight gain compared to sertraline.
– Bupropion (Wellbutrin): Associated with a small amount of weight loss (0.25 pounds) at six months, but the trend reversed with weight gain at 24 months.
Implications
The study findings underscore the importance of discussing potential weight gain with patients before starting antidepressant treatment. Dr. Roy Perlis, associate chief of psychiatric research at Massachusetts General Hospital, emphasizes that weight gain is a significant factor in individuals discontinuing antidepressants, despite their efficacy in treating depression. This awareness can help healthcare providers and patients make more informed decisions about treatment options.
Conclusion
Understanding the potential for weight gain with different antidepressants is crucial for both patient satisfaction and treatment adherence. Healthcare providers should weigh the benefits of antidepressant therapy against the risk of weight gain, considering individual patient needs and preferences.
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