Medicines and Weight Gain: Is Feeling Better Making You Fat?

by Marsha Hudnall

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Part I: Antidepressants, Anticonvulsants, Mood Stabilizers and Antipsychotics

Impact of medications on weight loss and weight gainDoes this sound like you? You started taking antidepressants with the hope they would give you a boost, but instead, you feel like they’re creating another problem. You’ve gained 20 pounds since you started them, and it looks like the pounds are continuing to pile on. Or maybe you don’t even realize it’s the medicine that’s causing the weight gain.

Either way, being informed makes for your best health care. While studies show a growing number of commonly prescribed medications – for conditions ranging from depression to high blood pressure — may cause weight gain, there may be alternatives that don’t have that effect, or may not cause as much weight gain as others.

The following chart lists the effect of antidepressants, anticonvulsants, mood stabilizers and antipsychotics on weight. Part II will review other medications and suggest weight-neutral alternatives for popularly-prescribed medications that you may discuss with your healthcare practitioner. If medication alternatives aren’t available, you may be able to discuss eating and exercise modifications with your nutritionist to help minimize weight gain.

Type of Medication Brand Name Effect on Weight Comments
Anti-Depressants
Selective Serotonin Reuptake Inhibitors (SSRIs) Paxil®
Zoloft®
Prozac®
Celexa®
Of popular SSRIs, Paxil has the most significant impact on weight gain. SSRIs cause less weight gain than tricyclic antidepressants
Tricyclic Antidepressants (TCAs) Elavil®
Janimine®
Tofranil®
Asendin®
Anafranil® Norepramine®
Pamelor®
Elavil, Janimine and Tofranil appear to cause greatest weight gain among TCAs. TCAs appear to slow metabolism and may promote carbohydrate cravings.
Monoamine Oxidase Inhibitors (MAOIs) Non-selective:
Marplan®
Nardil®
Parnate®Selective:
Manerix®
Humoryl®
Non-selective MAOIs are associated with weight gain.
Selective MAOIs appear to be weight neutral.
Other Antidepressants Desyrel®
Effexor®
Remeron®
Wellbutrin®
Serzone®
Remeron associated with significant weight gain.
Wellbutrin does not appear to be associated with weight gain. No data on Serzone re weight impact.
Anticonvulsants Tegretol®
Depakote®
Neurontin®Lamictal®
May cause hyperinsulinemia (high blood levels of insulin), which may increase appetite and testosterone levels and may lead to PCOS (polycystic ovarian syndrome), which is associated with obesity.Lamictal appears not to be associated with weight gain.
Mood Stabilizers Cibalith®
Duralith®
(both are brands
of lithium)
Associated with significant weight gain Studies show as many as two-thirds of patients taking lithium gain weight.
Antipsychotics Newer: 
Clozaril®
Zyprexa®
Risperdal®Older: 
Haldol®
Peridol®
Mellaril®
Novo-Ridazine®
Apo-Thioridazine®
Newer antipsychotics are associated with significant weight gain; of these, Clozaril and Zyprexa cause the most gain.Mellaril, Novo-Ridazine and Apo-Thioridazine appear to have the greatest potential for weight gain among older antipsychotics.

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