Have you ever played “Would you rather”? You know – the game where you’re put on the spot to answer a weird question truthfully. It can be a fun way to get to know people – but the questions can get really personal and even make you feel uncomfortable.

Like this one, would you rather be happy or thin?

Ouch. This question hits hard! You might be agonizing over this dilemma if you’re thinking about taking antidepressants for your depression but are scared you’ll gain weight. 

Weight gain can be a side effect of antidepressants. But not all antidepressants make you gain weight.

Not taking antidepressants out of fear of weight gain doesn’t have to be a roadblock to getting relief from your depression.

Mental health experts experienced in prescribing antidepressants can help you find the best option to avoid weight gain and use their advanced training to adjust your meds if needed.

Let’s set the record straight and go over how antidepressants affect your weight, which ones may potentially cause weight gain and which don’t, what factors add to weight gain in depression, and what you can do about it.

The Science Behind How Antidepressants May Cause Weight Gain

The truth is, having depression can cause your weight to fluctuate up or down even if you aren’t taking an antidepressant. Since some people with depression feel like eating more, while others lose interest in food, weight changes are common. And depression often leaves you feeling lethargic, meaning you burn fewer calories.

At the chemical level, we know antidepressants work by changing the amount of serotonin in your brain. But, serotonin affects more than your mood; it affects your appetite too. Taking antidepressants can also trigger intense cravings for carbohydrates. Indulging in these cravings can cause weight gain in some people.

But, adding an antidepressant to your treatment regimen doesn’t always lead to weight gain.

It’s difficult to pinpoint who will gain weight when starting antidepressant therapy. Data from a 2009 study showed 6% of patients studied taking SSRIs gained weight. A 2018 study of 260 patients who weren’t overweight when they began taking antidepressants concluded that those who had a weight gain of 3% in the first month of using an antidepressant were more prone to gaining weight over the long-term than those who gained less than 3%.

The science behind why antidepressants are linked to weight changes is still being explored. What we do know is which of these medications are more likely to result in weight gain.

Which Antidepressants Are Known for Causing Weight Gain?

The antidepressants most likely to cause weight gain don’t fall into one particular category. Here’s a breakdown of the different types most likely to cause weight gain:

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are the antidepressants most people are familiar with because they are the ones most commonly prescribed. Taking any of the following SSRIs for longer than six months may lead to weight gain:

• citalopram (Celexa)
• fluoxetine (Prozac)
• paroxetine (Paxil)
• sertraline (Zoloft)

Tricyclic Antidepressants (TCAs)

TCAs are one of the early classes of antidepressants. Even though TCAs are effective, mental health providers don’t prescribe these anymore because they are associated with many side effects, including weight gain. However, they can be useful if your depression doesn’t respond to other medications. This class of drugs includes:

• amitripyline (Elavil)
• amoxapine
• desipramine (Norpramin)
• doxepin (Adapin)
• imipramine (Tofranil-PM)
• nortriptyline (Pamelor)
• protriptyline (Vivactil)
• trimipramine (Surmonti)

Monoamine Oxidase Inhibitors (MAOIs)

This older class of drugs is not as commonly used because they can cause more side effects than the newer SSRIs. Despite these drawbacks, MAOIs can be beneficial in cases where other antidepressants aren’t helping. Specific forms of MAOIs associated with weight gain include:

• isocarboxazid (Marplan)
• phenelzine (Nardil)
• tranylcypromine (Parnate)

A newer MAOI, selegiline (Emsam), may even result in weight loss. This example reiterates that not all antidepressants lead to weight gain. And not everyone who takes them will gain weight. Lucky for the 13% of American adults taking antidepressants, there are many other options that don’t cause as much weight gain.

Which Antidepressants Result in Less Weight Gain?

If you’re concerned about gaining weight while taking antidepressants, be assured, there are many to choose from that tend to result in less weight gain than those listed above, like:

• bupropion (Wellbutrin, Forfivo, and Aplenzin)
• desvenlafaxine (Pristiq)
• duloxetine (Cymbalta)
• escitalopram (Cipralex, Lexapro)
• levomilnacipran (Fetzima)
• nefazodone (Serzone)
• venlafaxine (Effexor)
• venlafaxine ER (Effexor XR)
• vilazodone (Viibryd)
• vortioxetine (Trintellix)

If you’ve gained weight while using antidepressants, don’t just assume the medicine is to blame. Other factors may also play a role.

Other Factors Contributing to Weight Gain in People With Depression

When talking about antidepressants and weight gain, it’s only fair to consider other things that might be contributing to the fact you no longer fit in your favorite jeans.

The first one is something many people often forget – depression is an illness.

And, as with any illness, like an excruciating migraine, nasty cold, or a stomach bug, you know eating is the last thing you feel like doing.  But as you recover, your appetite comes back, along with any pounds you may have lost while sick. A similar thing can occur with depression. Many people who have depression simply don’t feel like eating. Taking antidepressants can make you feel better, resulting in an improved appetite. Once you’re eating more regular meals, you may regain the weight you lost when you felt more depressed. 

The decreased energy and lack of physical activity common with depression can also lead to your clothes feeling tighter and the number on the scale inching upward. If you’re still feeling lethargic on antidepressants, it could be a sign that your medication isn’t working well and needs to be changed.

Another thing to remember is the fact that most adults gain weight as they age, even if they aren’t on antidepressants. But, there are plenty of things you can try to maintain a healthy weight.

What Can You Do To Minimize Weight Gain While On Antidepressants?

When done gradually, developing lifestyle changes can help you manage the excess weight antidepressants may cause. Healthy habits that can help include:

• Increased physical activity
• Portion control
• Mindful eating 
• Avoiding processed foods and eating more fruits, vegetables, and protein

Fun distractions like these can also keep your mind off of eating:

• Hobbies
• Listening to music
• Spending time outside
• Exploring meditation
• Social activities

You get the picture. Changes like these can also help you grow and enjoy life more as you learn to manage your depression.

Don’t Let The Fear Of Weight Gain Stop You From Beating Depression

If you’re already feeling discouraged because you’re gaining weight while taking antidepressants, don’t stop taking your medication without talking to a mental health expert licensed to dispense prescriptions. We can evaluate you for any improvement in your symptoms and may be able to transition you to a different drug with a lower chance of weight gain without losing any progress you’ve made so far. 

Please don’t let the chance of gaining weight stop from antidepressants stop you from reaching out for help with your depression. The risks of letting depression go untreated are much more serious than the effects of weight gain.

At Upper Valley Behavioral Health, we’re highly experienced in troubleshooting antidepressant side effects, including weight gain. If you do gain weight on your medication, we’ll be happy to work with you to find an alternative medication regimen. 

Reach out to our mental health professionals for an online depression evaluation and prescription treatment plan. Apply today to be treated for your depressive symptoms.

Disclaimer: This post is for informational purposes only. It does not replace instructions from your licensed prescriber. Please consult your healthcare provider for guidance on your specific medication regimen.

Tags: weight gain, medication

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