How does Citalopram affect weight. What are the most common side effects of Celexa. Can Celexa cause weight loss. How much weight gain is typical with Celexa. Which antidepressants are most likely to cause weight gain.

Understanding Citalopram and Its Effects on Weight

Citalopram, commonly known by its brand name Celexa, is a selective serotonin reuptake inhibitor (SSRI) used to treat various mental health conditions. While its primary purpose is to alleviate symptoms of depression and anxiety, many individuals are concerned about its potential impact on body weight.

Does Citalopram cause weight gain or loss? The answer isn’t straightforward. Weight changes can occur while taking this medication, but they’re often mild and can vary from person to person. Let’s delve deeper into the relationship between Citalopram and weight fluctuations.

Citalopram and Weight Gain

Although Citalopram isn’t directly linked to weight gain, some users may experience an increase in body weight. This is often attributed to the medication’s positive effects on mental health, which can lead to improved appetite and eating habits.

For individuals whose depression or anxiety previously caused a decrease in appetite, the alleviation of these symptoms may result in weight gain as they return to normal eating patterns. It’s important to note that this weight gain is typically minimal and not a direct side effect of the medication itself.

Citalopram and Weight Loss

Interestingly, some individuals may experience weight loss while taking Citalopram. This can be due to side effects such as nausea, upset stomach, or changes in appetite. However, like weight gain, weight loss is not directly associated with the medication and varies among users.

Studies have shown that both weight gain and weight loss are possible outcomes when taking Citalopram. The key takeaway is that any changes in body weight are usually minimal and should not be a major cause for concern unless they are significant or rapid.

Common Side Effects of Citalopram

While weight changes may be a concern for some, it’s crucial to understand the full spectrum of potential side effects associated with Citalopram. The most common side effect reported is nausea, which typically subsides after a few days of treatment.

• Nausea
• Diarrhea
• Headache
• Changes in sleep patterns
• Dry mouth
• Increased sweating
• Sexual dysfunction

If you experience persistent or severe side effects, it’s essential to consult with your healthcare provider. They may adjust your dosage or consider alternative medications to minimize these effects.

Comparing Weight Gain Among Antidepressants

When considering antidepressant medications, it’s natural to wonder which ones are most likely to cause weight gain. While SSRIs like Citalopram can potentially lead to weight changes, some antidepressants are more commonly associated with weight gain than others.

Antidepressants Associated with Weight Gain

1. Paroxetine (Paxil, Pexeva)
2. Sertraline (Zoloft)
3. Escitalopram (Lexapro)
4. Fluoxetine (Prozac)
5. Mirtazapine (Remeron)
6. Amitriptyline (Elavil)

It’s important to remember that weight gain with these medications is often modest and can be managed through lifestyle adjustments. Your mental health should be the primary focus when considering antidepressant treatment.

Managing Weight While Taking Citalopram

If you’re concerned about potential weight changes while taking Citalopram, there are several strategies you can employ to maintain a healthy weight:

• Monitor your diet and maintain a balanced nutritional intake
• Engage in regular physical activity
• Stay hydrated
• Get adequate sleep
• Manage stress through relaxation techniques
• Consult with a nutritionist or dietitian for personalized advice

Remember, sudden changes to your medication regimen can be dangerous. Always consult with your healthcare provider before making any adjustments to your treatment plan.

The Importance of Individualized Treatment

Every individual responds differently to antidepressant medications. What works well for one person may not be as effective for another. This is why it’s crucial to work closely with your healthcare provider to find the most suitable treatment option for your specific needs.

Your doctor will consider various factors when prescribing Citalopram or any other antidepressant, including:

• Your specific mental health condition
• Severity of symptoms
• Previous medication history
• Potential drug interactions
• Your overall health status
• Personal preferences and concerns

By maintaining open communication with your healthcare provider, you can work together to optimize your treatment plan and address any concerns about side effects, including potential weight changes.

Long-term Considerations for Citalopram Use

When considering long-term use of Citalopram, it’s important to weigh the benefits against potential risks. For many individuals, the positive impact on mental health far outweighs any minor side effects or weight changes.

Benefits of Long-term Citalopram Use

• Sustained improvement in mood and emotional well-being
• Reduced risk of depressive episode recurrence
• Enhanced quality of life
• Improved social and occupational functioning

Potential Risks and Considerations

• Possibility of long-term side effects
• Potential for discontinuation syndrome if stopping medication abruptly
• Need for regular check-ups and monitoring
• Possible interactions with other medications or health conditions

Your healthcare provider will help you assess the long-term benefits and risks of Citalopram use based on your individual circumstances and health goals.

Alternative Treatment Options for Depression and Anxiety

While Citalopram can be an effective treatment for many individuals, it’s not the only option available. If you’re concerned about potential side effects or weight changes, you may want to explore alternative treatments for depression and anxiety.

Other Antidepressant Medications

• Other SSRIs (e.g., Fluoxetine, Sertraline)
• Serotonin-norepinephrine reuptake inhibitors (SNRIs)
• Atypical antidepressants
• Tricyclic antidepressants
• Monoamine oxidase inhibitors (MAOIs)

Non-Pharmacological Treatments

• Psychotherapy (e.g., cognitive-behavioral therapy, interpersonal therapy)
• Mindfulness and meditation practices
• Regular exercise and physical activity
• Lifestyle modifications (e.g., improving sleep habits, stress management)
• Complementary and alternative therapies (e.g., acupuncture, herbal supplements)

It’s essential to discuss these options with your healthcare provider to determine the most appropriate treatment approach for your specific situation.

The Role of Diet and Exercise in Managing Mental Health

While medication can play a crucial role in treating depression and anxiety, lifestyle factors such as diet and exercise can significantly impact mental health and potentially influence the effectiveness of medications like Citalopram.

Dietary Considerations

A balanced and nutritious diet can support mental health and potentially help manage weight while taking antidepressants. Consider incorporating the following into your diet:

• Omega-3 fatty acids (found in fatty fish, flaxseeds, and walnuts)
• Complex carbohydrates (whole grains, vegetables, legumes)
• Lean proteins
• Fruits and vegetables rich in antioxidants
• Probiotic-rich foods to support gut health

Exercise and Physical Activity

Regular exercise has been shown to have numerous benefits for mental health, including:

• Reducing symptoms of depression and anxiety
• Improving mood and self-esteem
• Enhancing cognitive function
• Promoting better sleep
• Helping maintain a healthy weight

Aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week, along with strength training exercises at least twice a week.

Monitoring and Adjusting Treatment

Successful treatment with Citalopram often involves ongoing monitoring and potential adjustments to ensure optimal effectiveness and minimize side effects.

Regular Check-ups

Schedule regular appointments with your healthcare provider to discuss your progress and any concerns. These check-ups may include:

• Assessing symptom improvement
• Monitoring side effects, including weight changes
• Evaluating overall health and well-being
• Discussing any new life changes or stressors

Dosage Adjustments

Your healthcare provider may need to adjust your Citalopram dosage based on your response to treatment. This process may involve:

• Gradually increasing the dose to achieve optimal effectiveness
• Reducing the dose if side effects are problematic
• Exploring alternative dosing schedules

Never adjust your medication dosage without consulting your healthcare provider, as sudden changes can lead to adverse effects or withdrawal symptoms.

Combination Therapies

In some cases, your healthcare provider may recommend combining Citalopram with other treatments to enhance its effectiveness or address specific symptoms. This might include:

• Adding psychotherapy sessions
• Incorporating complementary treatments like mindfulness or exercise programs
• Combining with other medications for specific symptoms (e.g., sleep aids for insomnia)

The key to successful treatment is open communication with your healthcare provider and a willingness to explore various options to find the most effective approach for your individual needs.

Celexa Side Effects: Weight Gain

For people who are curious about antidepressant medications, particularly selective serotonin reuptake inhibitors (SSRIs), the possibility of weight gain is sometimes a concern. Celexa, the brand name of the generic drug Citalopram, is a common type of SSRI that may be associated with a small gain in weight.

If you’ve been prescribed Celexa, or are just curious about this medication, you might be wondering: “Does Celexa cause weight gain?” Here’s what you need to know about gaining weight while prescribed Celexa. 

Does Celexa Cause Weight Gain?

Celexa itself is not known to directly cause weight gain. However, some people may experience weight gain as a result of their appetite improving from the positive effects of taking Celexa or another SSRI. 

For those who are taking Celexa to treat depression or anxiety, low appetite can be a common symptom. If you experience weight gain while being prescribed Celexa, it could be the result of many different factors—not all of which are a direct result of Celexa.  

How Much Weight Do You Gain on Celexa?

There is no specific amount of weight gain associated with Celexa. However, weight gain may occur with improved mental health symptoms from taking Celexa.

As indicated previously, any weight gain while taking Celexa could be caused by other factors besides the drug you’re taking. Unless you’ve gained more than a few pounds, there’s typically no cause for concern. 

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Can You Lose Weight While Taking Celexa?

Weight loss may occur while you’re taking Celexa, as a result of possible side effects like nausea or upset stomach—but weight loss is not directly associated with Celexa itself. To elaborate, studies have indicated that both effects are possible. 

Though it’s possible to gain or lose weight on Celexa, any body weight changes should be minimal.  

Which Antidepressants Cause the Most Weight Gain?

Serotonin selective reuptake inhibitors (SSRIs), a group to which Celexa belongs, can cause weight gain. These can include:

• Paroxetine (Paxil, Pexeva)
• Sertraline (Zoloft)
• Escitalopram (Lexapro)
• Fluoxetine (Prozac)

Weight gain may occur with the use of antidepressants, but this is sometimes due to an improvement of appetite, as one’s mental health begins to return. 

What Is the Most Common Side Effect of Celexa?

Nausea can be a common side effect associated with taking Celexa, but after a few days,  these symptoms should resolve. Other side effects of Celexa could include: 

• Nausea 
• Diarrhea
• Headache 
• Changes to sleep

Your doctor can work with you to adjust your dosage, or might even prescribe a different medication to help minimize any symptoms you might be experiencing. If you’ve been wondering, “Does Celexa cause weight gain?” and are currently taking this SSRI, don’t stop taking Celexa until you’ve talked with your psychiatric provider. 

They’ll work with you to taper down the dosage so that you can try a different prescription, or make further adjustments. 

Does Celexa Cause Weight Loss?

Celexa (also referred to by the generic name citalopram) is a selective serotonin reuptake inhibitor (SSRI). This class of antidepressant medication increases serotonin levels in your brain as a way of keeping your mental health balanced and treating depressive disorders. 

This prescription medication does tend to work for many people dealing with a depressive disorder. One review of studies found that it was superior to a placebo in the treatment of depression.

But symptoms of depression aren’t the only thing Celexa can be used to treat. It is also used in the treatment of obsessive compulsive disorder (OCD), panic disorder or panic attacks, social anxiety disorder, eating disorders, alcoholism and premenstrual dysphoric disorder.

As with any medication, there are potential side effects. One side effect that some people talk about is weight loss.

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Can Celexa Cause Weight Loss?

Citalopram is a prescription medication that can be taken in liquid or tablet form. Generally, a mental health professional will start you on a low dose and then increase it gradually. Doing so can help lower your risk of side effects.

Celexa is meant to be taken once a day with or without food. The starting daily dose for major depressive disorder is usually 10mg a day and the maximum dose is 20mg a day. 

Even if you start on a lower dose, you may experience side effects. Some of the more common side effects of citalopram include diarrhea, vomiting, nausea, heartburn, stomach pain, changes in your sex drive, decreased appetite and — yes — weight loss.

You should know, when it comes to weight fluctuations, it’s usually thought that antidepressants can lead to weight gain, rather than weight loss. There’s even evidence to back this up. In a large systematic review, it was found that most studies of weight changes and antidepressants concluded that there was an average of a five percent weight increase in people taking antidepressants. So, it may be confusing that one of the side effects is weight loss, rather than potential weight gain.

First, even though weight gain is a commonly-talked about side effect of antidepressants, it isn’t actually that common. Just 10 percent of people who are longtime users of SSRIs say they’ve gained some weight.

So, not everyone gains weight on antidepressants. And because one side effect of taking citalopram is a decreased appetite, you may notice you actually lose some weight. 

If you are bothered by any of the side effects of citalopram or you want to stop taking it for another reason, do not stop cold turkey. Instead, work with a healthcare provider to wean yourself off of it. By doing this, you can avoid withdrawal symptoms.

Other Causes of Weight Loss

If you are taking Celexa for depression and notice you’ve lost weight, it could be a bit of a chicken and the egg situation. This is because major depression can cause some people to eat more or engage in less physical activity due to low energy levels or mood swings. So, then, if they start taking citalopram and those depression symptoms (like lack of energy) go away, they may become more active or eat a bit less and notice weight falling away.

If your weight loss isn’t connected to your depression, you should seek medical attention to look for the root of the issue. While it’s normal for weight to fluctuate a bit each month or week, or even day by day, weight loss of 10 pounds or more in the span of six to 12 months without trying is considered unexplained weight loss. 

There are a variety of other things and medical conditions that can cause unexplained weight loss, including: 

In addition to these things, there are more serious things that can cause weight loss. These include cancer, drug misuse and more.

If you notice you are losing weight, you should speak to an online psychiatrist so that they can monitor it and help you find a cause. 

What to Do About Weight Loss

A little weight loss isn’t a big deal — heck, it may even be welcomed by some. But if you notice a significant weight loss, it’s worth repeating: You really should speak with a healthcare provider about what to do and what might be causing this weight loss. 

If it’s determined your weight loss was caused by a decreased appetite due to taking Celexa, there are a few things you can do to put the weight back on — should you want or need to. 

If your weight loss has put you below a healthy body weight, this will be particularly important.

Here are some things you can do to gain weight in a healthy way: 

• Reach for calorie-dense foods: Items like nuts and cheese are nutritious and filled with healthy fats. They will help bring more calories into your diet, so you can gain a little weight.

• Try a protein shake: Another way to boost calories in a healthy way is through drinking protein shakes. They pack a lot of calories in a small amount, so even if you’re not hungry, you should be able to get through one. 

• Go for many small meals: Can’t get through a big meal? No problem. Break your meals up into smaller meals throughout the day. The goal should be to eat every two to three hours. 

If you add about 500 calories a day to your regular diet, you should expect to gain about a pound a week.

The Connection Between Celexa and Weight Loss

Celexa is a medication that is most often taken for the treatment of depression and certain anxiety disorders. It is a selective serotonin reuptake inhibitor, which means it works by boosting levels of serotonin in your brain. 

Like with many other medications, there are common side effects associated with taking Celexa. One such side effect is changes in weight. 

While it’s commonly thought that taking an SSRI may make some people gain weight, for some, taking Celexa can lead to a loss of appetite and even weight loss. Usually, this is nothing to worry about and will subside as you adjust to taking this medication. 

If you are looking to gain weight back, you can increase the number of calories you consume a day. 

If you lose weight while on citalopram, you should talk to a healthcare professional for medical advice. They can help you decide if you want to switch antidepressants or give you tips about lifestyle tweaks you can make to help address your weight loss.

10 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

1. Citalopram. Medline Plus. Retrieved from https://medlineplus.gov/druginfo/meds/a699001.html
2. Chu, A., Wadhwa, R., (2021, May 10). Selective Serotonin Reuptake Inhibitors. Stat Pearls. Retrieved from https://www. ncbi.nlm.nih.gov/books/NBK554406/
3. Keller, M., (2000). Citalopram therapy for depression: a review of 10 years of European experience and data from U.S. clinical trials. Journal of Clinical Psychiatry. Retrieved from https://pubmed.ncbi.nlm.nih.gov/11206593/
4. Citalopram. National Alliance of Mental Illness. Retrieved from https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Citalopram-(Celexa)
5. Celexa. Highlights of Prescribing Information. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/021323s040lbl.pdf
6. Alonso-Pedrero, L., Bes-Rastrollo, M., Marti, A., (2019). Effects of antidepressant and antipsychotic use on weight gain: A systematic review. Obs Rev. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31524318/
7. Medication Frequently Asked Questions. National Alliance of Mental Illness. Retrieved from https://www.nami. org/FAQ/Mental-Health-Medication-FAQ/My-doctor-recently-started-me-on-an-antidepressant
8. Depression. Cleveland Clinic. Retrieved from https://my.clevelandclinic.org/health/diseases/9290-depression
9. Unexplained Weight Loss. Cleveland Clinic. Retrieved from https://my.clevelandclinic.org/health/diseases/17770-unexplained-weight-loss
10. How to Gain Weight Safely. Cleveland Clinic. Retrieved from https://health.clevelandclinic.org/how-to-gain-weight/

Active ingredient CITALOPRAM | Compendium – drug reference book

• Pharmacological properties
• Indications CITALOPRAM
• Application of CITALOPRAM
• Contraindications
• Side effects
• Special instructions
• Interactions
• Overdose
• Diagnosis
• Recommended alternatives
• Trade names

Medicinal preparations containing the active substance CITALOPRAM

Pram

film-coated tablets 20 mg No. 30

Bausch Health Companies Inc.

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Cipramil

film-coated tablets 20 mg, No. 28

Lundbeck Export A/S

Pharmacy prices

Zita Sandoz 9004 5 ®

film-coated tablets 10 mg, no. 20

Sandoz

Prices in pharmacies

Zyta Sandoz ^®

film-coated tablets 20 mg, No. 20, 100

Sandoz

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Zita Sandoz ^®

film-coated tablets 40 mg, No. 20, 100

Sandoz

Prices in pharmacies

citalopram is an antidepressant, belongs to selective neuronal reuptake inhibitors serotonin. The ability to bind to a number of receptors (including histamine, muscarinic and adrenoreceptors) is absent or very low, so citalopram is devoid of cardiotoxicity, sedative properties, does not cause orthostatic hypotension and some other side effects. It extremely slightly inhibits cytochrome P450 2D6, therefore it does not interact with those drugs that are metabolized with the participation of this enzyme. It does not affect intracardiac conduction, blood pressure, hematological parameters, liver, kidney function, and also does not contribute to weight gain. The antidepressant effect is usually achieved within 2-4 weeks after the start of treatment.

Oral bioavailability is about 80%. C _{max in blood plasma is achieved 2-4 hours after ingestion. Plasma protein binding – <80%. Metabolized by demethylation, deamination and oxidation. In plasma, it is detected mainly unchanged and changes in its concentration are characterized by linear kinetics. Steady-state plasma concentrations are reached 1-2 weeks after the start of treatment. T ½ is 1.5 days. Excreted with urine and feces.}

depression of various origins, panic disorders (including those with agoraphobia), obsessive-compulsive disorders.

At the beginning of treatment, adults are prescribed 20 mg orally once a day, regardless of food intake. Depending on the response to treatment and the severity of the disease, the dose can be increased to 60 mg / day. For elderly patients, the recommended daily dose is 20 mg, if necessary, it can be increased to 40 mg / day.

In hepatic insufficiency, the minimum daily dose is prescribed. In case of mild or moderate renal insufficiency, the dose is not necessary to be limited.

hypersensitivity to citalopram; treatment with MAO inhibitors (citalopram can be prescribed no earlier than 2 weeks after the abolition of MAO inhibitors, and treatment with the latter can be started only 7 days after the abolition of citalopram).

are usually mild, short-lived (mainly within 1-2 weeks after the start of treatment) and disappear without discontinuation of treatment. There may be a feeling of dry mouth, nausea, drowsiness, increased sweating, tremor; sometimes – a decrease in heart rate (clinically insignificant), and in patients with low heart rate, bradycardia may develop. If the patient has a current manic episode, citalopram should be discontinued.

The safety of taking citalopram during pregnancy or lactation has not been established, therefore citalopram is not recommended unless the expected therapeutic effect for the patient outweighs the potential risk to the fetus or newborn.

Citalopram should be used with caution in patients who drive vehicles or operate potentially dangerous machinery. Citalopram does not affect intellectual activity or psychomotor activity, but some weakening of attention may be noted when taking it.

taking citalopram concomitantly with MAO inhibitors can lead to the development of a hypertensive crisis (serotonin syndrome). Citalopram enhances the action of sumatriptan and other serotonergic agents. Cimetidine causes a moderate increase in the average equilibrium concentration of citalopram in blood plasma, this should be taken into account when using these drugs at high doses.

There is no evidence of an interaction of citalopram with lithium or alcohol, nor a clinically significant interaction of citalopram with phenothiazines or tricyclic antidepressants. Clinical studies have not established the interaction of citalopram with concomitantly used benzodiazepines, neuroleptics, analgesics, lithium, antihistamines, antihypertensive drugs, β-adrenergic blockers and other drugs acting on the cardiovascular system.

symptoms – drowsiness, coma, episodic convulsions, sinus tachycardia, increased sweating, nausea, vomiting, cyanosis, hyperventilation. There is no specific antidote, treatment is symptomatic and supportive.

how psychotropic drugs affect body weight and what to do about it

Obesity is a fairly common side effect of psychotropic drugs, on the one hand. On the other hand, the need for psychotropic drugs often arises due to obesity … This vicious circle can not be broken?

“Every Ukrainian needs a psychotherapist,” famous psychiatrist Semyon Fishelevich Gluzman said (mind you, even before the war, and even before Covid-19). Well, it’s hard to argue with that, but there aren’t enough therapists for everyone, and sales of antidepressants, antipsychotics, mood stabilizers, and tranquilizers are at record levels. Therefore, the pharmacist needs to update information about these medicines from time to time.

Psychiatrist, candidate of medical sciences, director of the training company “Radegost”, author of articles, books, educational programs, trainings in the field of psychiatry, psychotherapy, psychology, education Alexander ROSCHIN.

Alexander Roshchin

Psychiatrist, candidate of medical sciences

Overweight or obese?

Body weight is not the only indicator

Obesity is an imbalance between energy intake and expenditure, which leads to an increase in adipose tissue. A common practice is to determine the Body Mass Index (BMI: body weight in kg/height in m²).

BMI Definition

BMI Index/Interpretation

BMI (kg: m²)	Interpretation of the result
< 18.5	Underweight
18.5 – 24.9	Normal weight
25 – 29. 9	Overweight
30 – 34.9	Obesity stage I
35 – 40	Obesity stage II
> 40	Stage III obesity/morbid obesity*
OT** women > 80-88 cm	Abdominal obesity
OT men > 94 – 102 cm	Abdominal obesity

* Morbid obesity is a severe chronic disease that requires constant treatment, because in this condition the body is not able to function normally.

**Waist circumference is in accordance with current European and US regulations respectively.

BMI is an imperfect indicator because it does not take into account gender and age characteristics: men have a higher BMI, like middle-aged people. This is important to consider when assessing the dynamics of weight gain when taking psychotropic drugs.

When should action be taken?

When taking psychotropic drugs, the dynamics of body weight gain is considered acceptable when within 3 months after the start of taking psychotropic drugs a person gains 5-7% of the initial weight, and his BMI increases by 1 point.

If such dynamics are observed, this is enough to conclude that the drug chosen for therapy has the property of increasing body weight.

It should be taken into account that abdominal obesity is the most dangerous form of the disease due to the risk of developing metabolic syndrome, which is usually more typical for men, against the background of psychotropic drugs, it is also observed in women.

Recall that the metabolic syndrome (MS) is a complex of pathologies, each of which is dangerous, but in combination they pose a mortal danger to the patient. Not for nothing, MCs are also called “deadly quartet”:

Increased visceral fat mass → decreased sensitivity of peripheral tissues to insulin and hyperinsulinemia → impaired carbohydrate, lipid and purine metabolism → arterial hypertension.

See also

How is obesity formed under the influence of psychotropic drugs?

In general, a lot of mechanisms for the formation of obesity have been described today, but under the influence of psychotropic drugs this occurs in 2 main directions:

• Effect on monoamine receptors in the CNS (5HT, D, H) and
• Effect on hormones (adipose tissue, sex, prolactin, insulin).

So, under the influence of psychotropic drugs (usually neuroleptics and antidepressants): in food: appetite increases, the usual diet is disturbed (after all, a person feels tired as after physical labor), etc. → there is also a need for rest: hypnotic effect, refusal of physical activity.

Thus, there is an imbalance between consumption and energy consumption, which we have already mentioned.

With long-term (when therapy lasts months/years) blockade of H1 receptors of the hypothalamus → inhibition of the rostral raphe site (sympathetic premotor neurons) occurs and inhibition of thermogenesis → β3-AR act on brown adipose tissue → lipogenesis increases → lipolysis decreases.

All this leads to an increase in the volume of brown adipose tissue, which, as you know, is the most difficult to get rid of.

Psychotropic drugs block dopamine receptors . This reduces the ability to enjoy, and the ways of satisfaction are shifted towards basic needs, such as the consumption of high-calorie foods, etc.

The effect of psychotropic drugs on serotonin type C receptors (5HTC) is manifested both by their blockade (increased appetite) and activation 5HT2A , which is also characterized by a decrease in the level of satisfaction and the desire to compensate with high-calorie food, simultaneously with an increase in prolactin levels, which, in turn, increases insulin production.

It is well known that insulin is required for the transport of glucose to peripheral tissues (including the liver and adipose tissue). But psychotropic drugs can cause insulin resistance in these tissues.

Thus:

Glucose cannot reach the tissues → accumulates → increases insulin levels → this is perceived as excess energy → own energy reserves are not used → lipolysis stops.

Under the influence of psychotropic drugs, the level of prolactin also increases, which not only increases the level of insulin, but also affects the cells of the pancreas, stimulating additional production of insulin and everything happens according to the mechanism described above, and leads to the same result – the cessation of lipolysis, i. e. . increase in adipose tissue.

Psychotropic drugs also affect sex hormones . In men, there is a decrease in androgens, in women – an increase. Altered androgen levels (increased or decreased) also contribute to the development of resistance of hypothalamic receptors to tissue hormones (adiponectin, leptin, ghrelin), which contributes to increased appetite and the formation of adipose tissue.

See also

Monitoring and timely response

How to assess the cause of weight gain while taking antidepressants

Depression alone does not contribute to weight gain. After all, in this state, a person, on the contrary, loses his appetite. Therefore, in order to understand: what is the cause of extra pounds – the therapeutic effect of antidepressants (improving mood and appetite) or antidepressants themselves, you should pay attention to the following: if body weight has increased against the lost (for example, during depression a person lost 10 kg, and during therapy – gained 20 kg) or the weight continues to grow after the end of therapy, it is unlikely that we are talking about recovery, the reason is in antidepressants.

Antidepressants in relation to effects on body weight

Antiepileptic drugs for effects on body weight

Effect on body weight	Medicine
Reduce (can be prescribed without fear of weight gain and even added to other drugs for weight loss)	zonisamide, topiromate.
No effect	carbamazepine, oxcarbazepine, lamotrigine
Increase	valproates, lithium salts, gabapentin

Changing the drug

When it is necessary and how not to make a mistake

If, on the background of the prescribed therapy, there was an increase in body weight of ˃ 5% for ≥ 3 months, it is necessary to consider the possibility of changing the drug.

When it comes to the group of neuroleptics , we can:

• replace the atypical antipsychotic with a highly potent typical one (haloperidol, trifluoperizine) or
• with a 3rd generation neuroleptic – a partial agonist of dopamine receptors aripiprazole (Minintegra).

The trinity of antidepressants with the lowest incidence of obesity are ventafaxine, sertraline, and fluoxetine. Accordingly, it would be logical to replace drugs with one of the drugs of this trio. But all three of these drugs can increase anxiety. We need a drug that would control anxiety well and have minimal risks of weight gain. These include duloxetine (Symbia), which has an anti-anxiety effect comparable to paroxetine, but with a minimal likelihood of affecting adipose tissue and obesity due to the pronounced action of the norepinephrine component.

See also

Resume

Thus, psychotropic drugs should be selected by carefully weighing the individual characteristics of a person, taking into account possible side effects, and if necessary, replace them in a timely manner.

Especially as modern pharmacotherapy improves, drugs become more effective and safer. This, in turn, increases patient adherence to treatment.