Below is an excerpt and a table from The Cleveland Clinic Journal of Medicine (
Best Hospitals, The Cleveland Clinic ) that outlines which antidepressant RXs may cause weight gain and what can be done to counteract any weight gain effect.
I suggest you read the entire journal entry which is available online in .pdf (Adobe Acrobat File) at the following link:
http://www.ccjm.org/pdffiles/Deshmuhk703.pdf
You'll need Adobe Acrobat Reader to read the .pdf. If you don't already have it installed on your PC, you can download it for free here:
Adobe - Adobe Reader Download - All versions
Of course, you should consult your physician with your concerns and discuss a plan of action which will be most beneficial to you in controlling your depression and any weight gain.
Best wishes to you!
Quote:
CLEVELAND CLINIC JOURNAL OF MEDICINE VOLUME 70 • NUMBER 7 JULY 2003
Weight gain caused by antidepressant drugs is a major reason for patient noncompliance with treatment and poor treatment outcome. Knowing which drugs are more likely to cause weight gain in the short term and the long term is essential to any discussion with the patient about the risks vs the benefits of antidepressant therapy. Informing the patient up front about the chances of weight gain and what can be done if it occurs helps build a strong physician-patient relationship and promotes good treatment outcomes.
Weight gain is a serious concern for patients starting or already taking an antidepressant. Weight gain as a side effect of antidepressant therapy 1–5 in the short term (3 to 6 months) and the long term (1 year or longer) contributes to the reluctance of patients to continue or start treatment.2 Knowing how likely an antidepressant is to cause weight gain (TABLE 1) helps the physician select the best drug for the individual patient. Informing the patient about the chances of weight gain and what can be done about it helps build a strong physician-patient relationship and improves the effectiveness of treatment.
RECOMMENDATIONS FOR MANAGEMENT
Many patients prematurely discontinue their medication as a result of increased appetite or weight gain and may fall back into depression.
On the other hand, fighting weight gain once it has occurred can be very difficult, and it is advisable to consider the likelihood and potential consequences of weight gain when choosing an antidepressant.36,37
Educating the patient about the chances of weight gain as a side effect of treatment and its management is best accomplished through a strong patient-physician alliance and is integral to positive outcome.
Preventing weight gain in patients on antidepressants is the ideal strategy. It typically involves caloric restriction and increased caloric expenditure through aerobic exercise.1 Patients may benefit from a
nutritional consultation and participation in a low-cost commercial weight-loss program.
Individuals can be asked to record weekly weights, and thus both clinician and patient can be alerted to small increases in weight before the problem becomes too difficult.
Maintaining a food diary and behavioral techniques such as increasing meal frequency, smaller meals, or decreasing the pace of eating can help.
Switching to another drug with a lower risk of weight gain is an alternative approach, although this carries a risk of loss of clinical effect.
Addition of another agent such as a stimulant (methylphenidate, amphetamines), an H2 receptor antagonist (famotidine), triiodothyronine,
topiramate, bupropion, or naltrexone may help diminish weight gain.1,37
Although none has been tested systematically, low doses have been prescribed along with an antidepressant in an effort to avoid weight
gain associated with antidepressant therapy.
In our practice, we have found that adding low-dose bupropion (100 to 150 mg/day) or topiramate (25 to 50 mg/day) may help weight
loss when used in addition to diet control and exercise. |
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