Do Antidepressants Cause Weight Gain?

Weight gain has long been a common side effect of antidepressants, but some of them are more likely to add pounds than others, according to a new study.

The study, published on Monday in the journal Annals of Internal Medicine, analyzed the electronic health records of more than 183,000 U.S. patients who were considered first-time antidepressant users and tracked their weight for 24 months.

After six months, patients who took Lexapro, Paxil or Cymbalta had a higher risk, 10 to 15 percent, of gaining a clinically significant amount of weight, defined as at least 5 percent of their baseline weight, compared with users of Zoloft. Those taking Wellbutrin were less likely to experience this type of weight gain. The study included both the brand name and generic forms of each medication.

“A lot of patients are concerned about gaining excess weight when they’re taking an antidepressant,” said Joshua Petimar, who is an assistant professor of population medicine at Harvard Medical School and the Harvard Pilgrim Health Care Institute, and the lead author of the study. That may be especially true of patients with a pre-existing health condition like diabetes.

In addition, some patients might stop taking their antidepressant — even if it’s effective — because they don’t like that they’ve gained weight. “That also can kind of lead to a host of adverse outcomes like increased risk of hospitalization or relapse of symptoms,” Dr. Petimar said.

In the study, at six months the patients who took Lexapro or Paxil gained about a pound more on average than those who took Zoloft, which was the most commonly prescribed among the eight antidepressants that were tracked. People who took Cymbalta, Effexor or Celexa also initially put on more weight than did users of Zoloft, but in each case it was less than a pound. Those who took Wellbutrin, however, put on less weight than those who took Zoloft.

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