These 3 Antidepressants Make You Fattest, According to New Research
Antidepressants are among the most widely used and consumed drugs in the world. In particular, the latest European Health Survey in Spain found that 10.8% of the population have taken any of these drugs in the last two weeks. In addition, the latest OECD report with data for 2022 placed Spain in fifth place with the highest consumption rate, at 98 doses per day per thousand inhabitants. Now, a team of researchers from the Harvard Pilgrim Institute for Health Sciences has found out which drugs of this type are associated with more or less weight gain after starting treatment.
The results of the study were published in the journal Annals of Internal Medicine this Monday. Patients receiving bupropion experienced 15% to 20% less chance gain “clinically significant” weight than those taking sertraline. The experts considered a 5% increase in body weight to be significant. They used prescription data from electronic health records of 183,000 adults aged 18 to 80 who were taking antidepressants for the first time. They also compared weights at 6, 12 and 24 months after starting treatment to check for changes.
The authors looked at eight commonly used antidepressants: bupropion, sertraline, citalopram, escitalopram, fluoxetine, paroxetine, duloxetine, and venlafaxine. The first was the one that caused the least weight gain in patients. This quite a common side effect– explains the study, which can affect the long-term metabolic health of these people. In addition, it can also lead to them stopping the treatment prescribed by the specialist and worsening their situation.
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Prescribing antidepressants does not stop increasing from year to year and about 10% of Spaniards take them. Such studies are not only used for comparison purposes to distinguish one drug from another, remember that they all have the side effect of weight gain. This is a major issue because weight gain worsens physical health and quality of life, and also reduces people’s self-esteem, which is especially important when it comes to mental health, explained Alberto Ortiz, psychiatrist at the Carlos III Day Hospital – University Hospital La Paz (Madrid) in the Scientific Media Center (SMC) of Spain.
This study provides important evidence Scientists defend the weight gain that can be expected when starting treatment with antidepressants. During the study, it was noted that many patients were taking drugs that promote weight gain instead of widely available alternatives of the same type.
Sertraline, escitalopram, and paroxetine are examples of this. They are all selective serotonin reuptake inhibitors (SSRIs), the most common type of antidepressant. However, escitalopram and paroxetine have been linked to the risk is about 15% higher clinically significant weight gain than sertraline in the first 6 months. Thus, the three antidepressants that are most associated with weight gain are: escitalopram, paroxetine and duloxetine. The authors argue that with this information, patients and their doctors can consider weight gain as one reason to choose the drug that best suits their needs.
Ortiz tells SMC in Spain that similar investigations show that we need to warn you properly about the side effects for patients who are going to take them. It also encourages us to consider whether they can be prescribed with an informed consent document, such as one signed before surgery or other treatment.
Camilla Lasalle, associate professor specializing in nutritional epidemiology and cardiovascular health at ISGlobal, highlighted to SMC in Spain the innovative nature of the study design. He also pointed out its methodological rigor and the large sample size. He believes that the results may be limited by the fact that the observation period for weight change is “relatively short”, being only two years. The expert also misses the opportunity to learn about the lifestyle factors of patients (diet, alcohol consumption, physical activity…) that influence weight gain.
For a psychiatrist, the importance of such work lies in the possibility of informing all those who need it about the “harm” that antidepressants can cause. The results of such studies may help limit the prescription of these drugs to people who would “really” benefit from this type of treatment, he told SMC Spain. The specialist maintains that much of the mental suffering can be resolved through social or psychological interventions, without resorting to antidepressants. However, he regrets that the latter is the most frequent and immediate reaction that patients experience.