2023-08-18 08:36:45
Among the side effects that patients attribute to antidepressants, weight gain is among the most troublesome. Is it a myth or a reality? For Dr. Hervé Javelot, ” it’s a undeniable reality. But not all antidepressants are created equal. answers this pharmacist, head of the center of resources and expertise in psychopharmacology of the Grand Est.
Antidepressants that don’t really change weight
THE selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, paroxetine or sertraline, are among the most frequently prescribed antidepressants today. At the start of treatment, these SSRIs would have tend to lose weight. They can, in fact, cause some digestive discomfort (nausea, diarrhoea, etc.) which tend to suppress the appetite. Fortunately, these side effects fade over time, and eventually everything is back to normal. After six months to a year of treatment, the assessment of the impact on weight is “pretty neutral” according to Dr Javelot.
In the longer term, the painting must be “nuanced”would like to point out the specialist: “Among the data available with SSRIs, a study on panic disorder shows weight gain with these treatments following one year, while another retrospective study with a follow-up of 4 years shows an average increase in weight of almost 5 %”, he observes.
The pattern is essentially the same with another class of antidepressants: serotonin and norepinephrine reuptake inhibitors, such as venlafaxine or duloxetine. These drugs have no no really significant effect on weight.
Some Antidepressants Clearly Stimulate Appetite
THE tricyclic antidepressantssuch as amitriptyline or clomipramine, have tendency to open the appetitewhich in some patients may result in weight gain. These tricyclics are prescribed only following failure of other drugs.
Other antidepressants, mirtazapine and mianserin can also cause slight weight gain, despite a different mode of action from tricyclics.
Depression also has an impact on weight
“Weight gain related to taking an antidepressant remains, in general, limited to two or three kilos on average », reassures Dr. Javelot. The actual impact varies from person to person, depending on the disease. Two scenarios are possible:
In most cases of depression, the person no longer wants anything, they are no longer interested in food and they suffer from insomnia. Ultimately, she is losing weight. In these patients, the weight gain associated with taking an antidepressant will most often go unnoticed. “The person recovers his weight and will not be alarmed”, observes Dr. Javelot.
More rarely, some depressive patients tend to put on weight because they sleep too much (hypersomnia) and their appetite is increased tenfold. In this case, it is to be expected that taking certain antidepressants will accentuate the phenomenon.
Another parameter to take into account: anxiety. It often accompanies depression, with variable effects on appetite and therefore on weight. “In a stressful situation, some people no longer eat, others take refuge in snacking”, recalls Dr. Javelot.
Finally, medications other than antidepressants can cause weight gain. This is the case of mood stabilizers such as lithium, mood regulators indicated in bipolar disorders.
How to avoid weight gain?
Faced with this adverse effect, some patients are tempted to stop their antidepressant treatment. This is obviously not the right option. On the contrary, it is better to speak openly regarding the subject with your doctor, because solutions alternatives existent : “whatever the drug strategy, there is the possibility of adapting”, reassures Dr. Javelot. Each class of antidepressants has several molecules that do not all have the same side effects. The doctor can modify his prescription to take this into account.
To fight once morest these extra kilos, the classic advice remains valid. Ideally, you should limit fatty and sugary foods and move more to avoid gaining weight. In reality, this wise advice cannot always be followed. “Depression is often accompanied by a psychomotor retardation which does not facilitate the practice of physical activity, even if it is beneficial. The difficulties are the same when it comes to food,” observes Dr. Javelot.
For this specialist, it is important that the doctor “tend a pole” to his patient by asking him regarding the side effects of his medication. “It is recommended that a patient put on an antidepressant be reviewed once a week at the start of treatment to discuss, in particular, tolerance”, he recalls.
1692535119
#antidepressants #fat #Health #Magazine
