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Do antidepressants affect weight? Will long-term medication make you fat?

Time:2022-09-26 01:03:55 source:psychiatricethics.com author:Anxiety disorder Read:470次
Do antidepressants affect weight? Will long-term medication make you fat?

In clinical work, our doctors often receive a lot of questions like: "Does the antidepressant drugs I take affect my weight?" "Will the drugs contain hormones? If I take the drugs to gain weight, I would rather not take them." Such a paper was published in the journal Neurological Disorders and Mental Health, "Research Advances in the Mechanisms of Antidepressant Drug Effects on Weight." This article compares the effects of common antidepressant drugs on body weight. According to the degree of impact on body weight, it is divided into: if a significant increase in body weight > 7% and ≥ 1.5 kg is reported in short-term and/or long-term treatment, the Antidepressants are classified as high-risk drugs; reported significant weight gain of 7% and weight gain of 0.5-1.4 kg, the antidepressants are classified as intermediate-risk drugs for weight gain; affect body weight, the antidepressant is classified as a low-risk drug. 1. Antidepressants with a higher risk of weight gain (1) Paroxetine, a prescription drug used to treat a variety of psychiatric disorders, including depression, obsessive-compulsive disorder, and post-traumatic stress disorder, as well as anxiety and phobias. Compared with other SSRIs, paroxetine showed a significant increase in patient-reported weight. Reports show a weight gain of 2.73 kg over 4 months of paroxetine use. About 13% of patients taking paroxetine reported a weight gain of more than 7% after 9 months of follow-up. Therefore, significant weight gain may occur after long-term treatment with paroxetine, requiring regular monitoring of body weight. (2) Mirtazapine, which is a NaSSA class of drugs, mainly used to treat depression. Mirtazapine has been shown to increase body weight by 1.74 kg for short periods of time such as 4 to 12 weeks. Use more than 4 months can increase 2.59 kg. About 22% of patients taking mirtazapine reported a weight gain of more than 7% at 9 months. The combined activity of mirtazapine at histaminergic and 5-HT receptors results in a high risk of weight gain with both short-term and long-term use. (3) Citalopram is the most widely used SSRIs antidepressant. Data on weight change during short-term and maintenance treatment found a significant weight gain of 1.69 kg after 4 months of treatment. The findings suggest that citalopram is associated with severe, long-term weight gain, and weight monitoring is recommended. Second, antidepressants with moderate risk of weight gain (1) Sertraline, sertraline is a commonly used first-line prescription drug for the treatment of depression and obsessive-compulsive disorder. During short-term treatment periods, such as 4 to 12 weeks, sertraline may exhibit mild or weight-reducing effects. However, most findings suggest that the effect of long-term maintenance therapy on weight gain is moderate. (2) Escitalopram. It has less effect on body weight than citalopram hydrobromide. The findings suggest a lower risk of weight gain during long-term and maintenance therapy. (3) Duloxetine. It is used to treat depression and is also approved to treat chronic pain. Body weight was lost during the brief treatment period with no effect on body weight during the maintenance period. Weight gain was positively associated with duloxetine prescription, increasing gradually over time. Available findings suggest that duloxetine is associated with a moderate risk of weight gain during long-term treatment. 3. Antidepressants with lower risk of weight gain (1) Fluoxetine. It is used to treat depression, obsessive-compulsive disorder, and bulimia nervosa. Studies investigating weight changes associated with fluoxetine have been largely inconclusive. Current literature suggests that long-term fluoxetine use may require weight monitoring; however, short-term fluoxetine use usually has no significant effect on body weight. (2) Venlafaxine. Available clinical results suggest no short-term treatment effects and moderate long-term weight gain in patients taking venlafaxine. (3) Vortioxetine, a multimodal antidepressant approved for the treatment of depression, has strong efficacy in many clinically important areas of depression symptomatology. Clinical trials have shown a low incidence of weight change in patients taking vortioxetine. Preliminary findings suggest the drug is a viable first-line antidepressant with minimal impact on body weight. (4) Trazodone, an antidepressant that has no significant effect on body weight. But its antidepressant effect is not very good, which affects its clinical use. The drug is better for insomnia. (5) Bupropion. It is the only drug shown to significantly reduce weight, and the weight-reducing effects of bupropion make it particularly suitable for obese depressed patients. (6) agomelatine, which is also a commonly used antidepressant, is especially suitable for depressed patients with insomnia or sleep rhythm disorders. It also has little effect on weight. Weight changes caused by antidepressants are common adverse effects, including central and peripheral mechanisms, involving histaminergic, cholinergic, 5-HT, norepinephrine, dopamine, and peripheral effects. Weight gain is a known risk factor for obesity, cardiovascular disease, diabetes, and premature death, and affects medication adherence. Therefore, during antidepressant treatment, close monitoring of weight changes should be prioritized, and drugs that have little effect on weight should be selected. At the same time, it is necessary to monitor the metabolic indicators of antidepressants in clinical practice. Given the high risk of some antidepressants affecting body weight, it should be paid more attention. Of course, if a patient is on an antidepressant medication that is at high risk for weight effects, but is stable and does not gain significant weight, try not to switch medications. I am a psychiatrist Jiang Xueqin. I have 40 years of clinical work experience in psychiatry. If you have depression, anxiety, bipolar affective disorder and other related problems, you can consult me. Welcome to follow my headline private message and leave a message, I will draw time to reply.

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