- With Mayo Clinic psychiatrist
Daniel K. Hall-Flavin, M.D.
read biographyclose windowBiography of
Daniel K. Hall-Flavin, M.D.
Daniel K. Hall-Flavin, M.D.
Dr. Daniel Hall-Flavin, board certified in general psychiatry and addiction psychiatry, is a St. Louis native looking to the Internet as a way to help people improve their health and be more active participants in their own health care by learning from Mayo Clinic's experts.
Dr. Hall-Flavin served on the faculties of Cornell University Medical College, New York Medical College and The George Washington University Medical School before joining the Mayo Clinic staff in 1996. He has special interests in adult psychiatry, addiction psychiatry, pharmacogenetics and personalized medicine. He served as medical director of the National Council on Alcoholism and Drug Dependence from 1986 to 1999, and is currently involved in translational medicine research involving the introduction of pharmacogenetic technology into the daily practice of community psychiatry.
"With the advent of pharmacogenetics and related fields and the advances in translational medicine, informed collaborative relationships between knowledgeable, capable health professionals and informed, proactive individuals and their families are more vital than ever," he said.
"I'm optimistic that our Internet health education activities will contribute to ever-improving health outcomes for all who participate and apply what is learned."
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Question
Antidepressants and weight gain: What causes it?
Can antidepressants cause weight gain?
Answer
from Daniel K. Hall-Flavin, M.D.
Weight gain is a possible side effect of nearly all antidepressants. However, each person responds to an antidepressant differently. Some people gain weight when taking a certain antidepressant, while others don't.
Generally speaking, some antidepressants seem more likely to cause weight gain than others. These include:
- Certain tricyclic antidepressants, such as amitriptyline, imipramine (Tofranil) and doxepin (Silenor)
- Certain monoamine oxidase inhibitors (MAOIs), such as tranylcypromine (Parnate) and phenelzine (Nardil)
- Paroxetine (Paxil), a selective serotonin reuptake inhibitor (SSRI)
- Mirtazapine (Remeron), which is an atypical antidepressant — medication that doesn't fit neatly into another antidepressant category
While some people gain weight after starting an antidepressant, the antidepressant isn't always a direct cause. Many factors can work together to contribute to weight gain during antidepressant therapy. For example:
- Overeating or inactivity as a result of depression can cause weight gain.
- Some people lose weight as part of their depression. In turn, an improved appetite associated with improved mood may result in increased weight.
- Adults generally tend to gain weight each year, regardless of the medications they take. Getting regular exercise and watching what you eat will help you maintain a healthy weight, whether you take an antidepressant or not.
If you gain weight after starting an antidepressant, discuss the medication's benefits and side effects with your doctor. If the benefits outweigh the side effect of weight gain, consider managing your weight by eating healthier and getting more physical activity while enjoying an improved mood due to the medication. You can also ask your doctor if adjusting the dose or switching medications might be helpful — but again, be sure to discuss the pros and cons before making such a decision.
Next questionAntidepressant withdrawal: Is there such a thing?
- Hasnain M, et al. Weight gain and glucose dysregulation with second-generation antipsychotics and antidepressants: A review for primary care physicians. Postgraduate Medicine. 2012;124:154.
- Bostwick JM. A generalist's guide to treating patients with depression with an emphasis on using side effects to tailor antidepressant therapy. Mayo Clinic Proceedings. 2010;85:538.
- Taylor VH, et al. Beyond pharmacotherapy: Understanding the links between obesity and chronic mental illness. Canadian Journal of Psychiatry. 2012;57:5.
- Practice guideline for the treatment of patients with major depressive disorder. Arlington, Va.: American Psychiatric Association. http://www.psychiatryonline.com/pracGuide/pracGuideTopic_7.aspx. Accessed Oct. 16, 2012.
- Serretti A, et al. Antidepressants and body weight: A comprehensive review and meta-analysis. Journal of Clinical Psychiatry. 2010;71:1259.
- Kung S (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 17, 2012.
- Vieweg WVR, et al. Psychotropic drug considerations in depressed patients with metabolic disturbances. The American Journal of Medicine. 2008;121:647.
- Dent R, et al. Changes in body weight and psychotropic drugs: Systematic synthesis of the literature. PLOSone. 2012;7:e36889. http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0036889. Accessed Oct. 18, 2012
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