New research is comparing weight changes in patients taking different types of antidepressants, one of the most prescribed medications in the United States.
The study, published Tuesday in the Annals of Internal Medicine, analyzed data from 183,118 patients in 8 U.S. health systems between 2010 and 2019. It found that some antidepressants were associated with more weight gain than others .
At six months, users of escitalopram (sold under the brand name Lexapro), paroxetine (Paxil), and duloxetine (Cymbalta) were 10% to 15% more likely to gain at least 5% of their starting weight than sertraline (Zoloft). users
Bupropion (Wellbutrin) users were 15% less likely to gain weight than sertraline (Zoloft) users, while fluoxetine (Prozac) use was not associated with weight change.
The study authors describe these as “small differences,” but they hope the findings will help patients and providers make more informed treatment decisions.
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“Patients and their doctors often have several options when starting an antidepressant for the first time. This study provides important real-world evidence about how much weight gain should be expected after starting some of the more popular antidepressants.” common,” lead author Joshua Petimar. , assistant professor of population medicine at Harvard Medical School at Harvard Pilgrim Health Institute, said in a news release.
The study had some limitations, including a lack of consistent information on medication dose and adherence. It is also observational, meaning it shows correlation but not causation.
Although the study shows that certain drugs are correlated with weight gain, it does not necessarily mean that the drug is directly causing this weight gain.
For example, if someone lost their appetite because of depression and takes a drug that helps with your symptoms, weight gain could follow without the drug being directly responsible.
In this example, “it's the treatment of depression and, subsequently, the recovery of appetite that is causing weight gain,” explains Dr. Aron Tendler, a psychiatrist and chief medical officer of the health technology company BrainsWay.
What the study revealed about how many people stopped taking their medication is also important, Tendler said.
“Generally, when someone prescribes a drug, they really should be on it for a year,” he said. “The amount of people stopping their medication at three, six and 12 months was incredibly high. Only 4% of people stayed on their medication for 24 months.”
Although the odds of weight gain “are not very high,” Tendler said, the main takeaway for patients and doctors is that there are multiple options if someone is concerned about weight gain.
“People can switch to other medications,” he said, which could help improve adherence and treatment outcomes. “There are also non-medical treatments like, for example, TMS (transcranial magnetic stimulation) … I think people should consider that.”
Government data from 2017 showed the use of antidepressants increased by 65% between 1999 and 2014. Recent studies have shown the impact of the COVID pandemic on the increase in the use of antidepressants among young people. For 12- to 25-year-olds, antidepressant use increased nearly 64 percent since the start of the COVID-19 pandemic, according to a study earlier this year.
