Seeking help for
depression — and following through with antidepressant medication — is a
courageous and important first step on the road to recovery. But too often,
those who take that step find themselves faced with another troubling problem:

weight gain.
Experts say that for up to 25% of people, most antidepressant medications –
including the popular SSRI (selective serotonin reuptake inhibitor) drugs like

Prozac,
Lexapro,
Paxil, and
Zoloft — can cause a weight gain of 10 pounds or more.
“This is a phenomenon that I first noticed years ago when Prozac first
came on the market. It didn’t initially show up in the clinical trials because
most of them were eight to 12 weeks in length, and the weight gain generally
occurs with longer use. But it’s definitely one of the side effects of this and
other antidepressant medications,” says Norman Sussman, MD, a psychiatrist
and associate dean for postgraduate medical programs at the NYU School of
Medicine.
A review published in 2003 in the Cleveland Clinic Journal of
Medicine stated that while weight gain is a possible side effect with SSRI
antidepressant drugs, it may be more likely to occur after six months or more
of use.
But SSRIs aren’t the only class of antidepressants that may have weight gain
as a side effect. Other antidepressant medications, including tricylics (like

Elavil and Tofranil) and MAO inhibitors (drugs like Parnate and Nardil),
may also cause patients to gain weight with both long-term and short-term
use.
“This is clearly a problem for the majority of drugs used to treat
depression, and while it doesn’t occur with every drug or for every person,
when it does happen, it can be a significant problem that we shouldn’t just
ignore,” says Jack E. Fincham, PhD, RPh, professor of pharmacy practice at
the School of Pharmacy at the University of Missouri at Kansas City, and author
of The Everyday Guide to Managing Your Medicines.
Antidepressants and Weight Gain: What Happens and Why
Although there are a number of theories as to why antidepressants lead to
weight gain, Sussman believes that both appetite and metabolism may be
affected.
“I have had patients who swear that they are not eating any more, but
still gaining weight, so that tells us there is some kind of metabolic
influence going on; I have also had patients tell me that they are not only
more hungry and eating more, but that the medicines are encouraging a
carbohydrate craving that is hard to control, so we know appetite also plays a
role,” he says.
Fincham says antidepressants may also simply help us to rediscover pleasure
in our life — including food.
“It might be a situation where someone feels so much better when taking
an antidepressant that lots of things suddenly start feeling more pleasurable
to them, and food is just one of them. So in this instance they may actually be
overeating and not even realize they are doing so, says Fincham.
Findings from a group of Italian researchers published in the journal
Psychotherapy and Psychosomatics suggest that the simple act of recovery
from depression may play a role in the weight gain.

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