Antidepressant medications, appetite, and weight
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The prescription drugs listed below are used for many problems other than, including: insomnia, obsessive-compulsive disorder,, and anxiety. It is important to understand why you have been prescribed these medications and to be assertive with yourcaregivers if you feel you are having complications that outweigh the beneﬁts of using them. There may be another medication that oﬀersmore beneﬁts with fewer side eﬀects--before completely stopping the medication, ask about other possibilities.
The comments in the third column are a work in progress. The information included is by no means all-inclusive, but it does provide an idea ofwhat kind of interactions with food and weight have been scientiﬁcally observed and recorded in the National L ibrary of M edicine P ubM eddatabase. All references are included below the chart.
We limited studies reported to double-blind designs, which means that neither the subjects nor the researchers knew during the study who wasreceiving the real drug and who was receiving the placebo. This is a research design that helps to reduce bias in reporting results. Weight gainafter starting a medication regime is typically one of two kinds: (1) regain of weight that was lost due to anxiety/depression (this may actuallybe a positive sign of restored health) and (2) weight gained over and above any weight change experienced before the onset ofanxiety/depression (this may be a sign of a negative medication side eﬀect). S imply reporting that weight gain occurs with the use of amedication is not enough. A double-blind design is needed to more accurately evaluate which kind of weight gain a particular medication isprone to cause, and whether or not this is cause for concern.
1. O ur N utritional I mplications of P sychotropic M edications C D
summarizes the neurophysiological, hormonal (with emphasis on
diabetic/P CO S potential), and nutritional (weight/appetite) aspects of 58 psychotropic medications in the antidepressant, anxiolytic, mood
stabilizing, antiepileptic, antipsychotic, anti-Parkinson's, Alzheimer's, and psychostimulant categories.
--Which psychiatric medications interfere with fertility
--Which psychiatric medications are associated with diabetes and metabolic syndrome
--Which medications aﬀect vitamin and mineral metabolism
--Oﬀ label uses for these medications
We surfed thousands of P ub M ed abstracts so you don't have to!
2. N ew! T his I s Your B rain O n P sych D rugs
is our brand-new consumer publication that provides an introduction to psychotropic
medications and their nutritional perspective. It provides a summary of the most popularly linked information on our sister blog, presented in
3. B ecause this page received so much traﬃc and because the format in the above resource did not allow for me to write about many important
aspects of psychiatric medications, I started a new blog
. Please visit!
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T HI S C HART L AS T UP DAT E D M AY 26, 2007.
Reduces appetite for sweets (1).
Signiﬁcantly reduced binge eating episodes (2).
Eﬀective in the treatment of binge eating disorder (3, 4).
Meta-analysis suggests weight loss eﬀect (5).
In rats, observed to decrease food intake in the 2 to 8 hour period following
In 1159 subjects, reduced weight by an average of 0.2 kg (7).
In a study of 128 individuals, weight modestly increased over a 2 year period (8).
In a study of 1279 patients, average weight gain after a year was 2.4 kg (9).
Useful in the treatment of binge eating disorder (10).
Reduces food intake (11).
Weight loss has been reported (12).
In rats, observed to decrease food intake in the 2 to 8 hour period following
In a sample of 144 patients treated over a course of 8 weeks, signiﬁcant weight gain was
In a systematic review of antidepressants, had the highest incidence of weight gain (14).
Weight gain has been reported (15).
In a systematic review of antidepressants, had "intermediate potential" for weight gain
Weight gain has been reported (16).
Reduces symptoms of bulimia (17).
No weight gain reported in a 4 week study in individuals with depression (18).
May have therapeutic beneﬁt in reducing symptoms of bulimia (19).
Decreases appetite (20).
Reduces symptoms of bulimia (21).
In a study of 32 elderly patients treated for 8 weeks, those who gained the most weight
were the ones who had lost the most weight prior to using medication. Degree of
weight loss associated with depression was correlated with the severity of depression
A total of 96 patients with major depressive disorder were given paroxetine and
compared to similar groups on sertraline and ﬂuoxetine. The patients were treated for
26-32 weeks. A signiﬁcantly greater number of patients receiving paroxetine than those
on the other two drugs gained 7% of their original weight or more during the course of
In a sample of 144 patients treated over a course of 8 weeks, no signiﬁcant weight gain
was observed (13).
3% of a sample of approximately 100 subjects lost weight over 8 weeks of treatment
with an average dose averaging 25.5 mg per day (14a).
Less weight gain when compared to mirtazapine in a 6 week study of 123 patients
averaging a dose of 22.9 mg/day (24).
A review of over 1800 research subjects with generalized anxiety disorder did not show
any signiﬁcant increase in weight (25).
A marked association between general and abdominal obesity has been reported (26).
Reduces food intake and is associated with weight loss in depressed and otherwise
healthy individuals (23, 27-30).
Weight changes are dependent on weight at onset of use; weight loss is observed in
persons whose weight is classiﬁed as "overweight," "ideal" weight persons gained some
weight, and "underweight" persons showed now signiﬁcant weight trend (31).
F luoxetine plus behavior modiﬁcation therapy resulted in greater weight loss than
ﬂuoxetine alone. Protocol did not appear to help with binge eating (32).
Signiﬁcant reduction in body weight in women with bulimia who used the drug in
combination with intensive psychotherapy (33).
Improved symptoms of bulimia, including: depression, carbohydrate craving, and
dysfunctional eating a itudes and behaviors (34, 35, 36, 37).
A modest but insigniﬁcant number of 44 patients receiving treatment for 26 to 32 weeks
gained more than 7% of baseline weight (23).
11.88% of a sample of approximately 100 subjects lost weight over 8 weeks of treatment
with an average dose averaging 27.5 mg per day (14a).
Helps to lose weight in obsessive-compulsive disorder (38).
Weight gain reported on doses of 15-60 mg over 8 weeks of treatment (39).
Weight gain reported on average dose of 32.7 mg over 6 weeks of treatment (40).
Weight gain in 50% of individuals receiving an average of 18.3 mg over 8 weeks (41).
Weight gain averaged 1.4 kg over 40 weeks of treatment on a dose of 15-45 mg (42).
No weight gain reported with an initial dose of 15 mg (increased to 30 mg when
needed) over 4 weeks of treatment (43).
More weight gain when compared to paroxetine in a 6 week study of 127 patients
averaging a dose of 32.7 mg/day (24).
In 147 patients treated with mirtazapine, the average weight gain was 0.8 lbs. (38).
Trend toward increased appetite and weight (44).
Increased a preference for sweets in 15% of a test sample (45).
Weight gain has been reported (46, 47).
Perception of weight change altered with treatment; a 5 lb. weight change was more
problematic during recovery than during depression (48).
Reduces binge duration in obese bingers (13, 14a); adding this drug to nutrition and
psychological counseling helps with weight loss even for at least 6 months oﬀ of
Reduces symptoms of bulimia (24).
Is currently under investigation as a potential component of obesity treatment (49, 50).
Meta-analysis suggests weight loss eﬀect (5).
Associated with weight reduction (50).
Reported to decrease food intake and weight (54).
A modest but insigniﬁcant number of 48 patients receiving treatment for 26 to 32 weeks
gained more than 7% of baseline weight (23).
Inhibits food intake and decreases weight without aﬀecting locomotion (51-53).
In individuals with obsessive-compulsive disorder, an average weight gain of 4.5% was
experienced during a 2 year period of using this medication (54).
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