The Best Antidepressants for Weight Loss

Wellbutrin or Prozac May Be Sensible Options for Avoiding Weight Gain

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Many people with depression have worked hard to treat their disease by attending therapy and taking their antidepressants, only to find that now the numbers on the scale are rapidly moving up and their clothes are not quite fitting like they used to. You may feel better emotionally and mentally, but maybe you're discouraged by your physical appearance and/or health.

Antidepressants and Weight Gain

Weight gain while taking an antidepressant is a conundrum that can leave many people scratching their heads, even doctors. If a person gains weight, it's sometimes unknown whether the weight gain is from a side effect of the antidepressant itself or from the fact that he or she is feeling better and is probably eating more.

On the flip side, if you have atypical depression, a subtype of major depressive disorder, weight gain is common. In this instance, with antidepressant treatment, further weight gain may indicate failed treatment or it could be medication-induced—a tricky, but extremely critical distinction.

To further complicate the picture, while many people associate antidepressant use with weight gain, there is actually limited scientific evidence to back this up. In fact, research shows weight gain is mostly linked only to these three antidepressants:

  • The selective serotonin reuptake inhibitor (SSRI) Paxil (paroxetine)
  • The tricyclic antidepressant Elavil (amitriptyline)
  • The atypical antidepressant Remeron (mirtazapine)

Weight gain associated with other antidepressants, if it does occur, is usually short-lived. In addition, individual factors seem to play a role.

In other words, it's hard to predict who will gain weight on certain antidepressants as so many variables are at play.

Antidepressants and Weight Loss

You may be surprised to learn that there are two antidepressants linked to weight loss. Remember, a link implies a statistical association, so it does not predict individual results. These include:

  • The selective serotonin reuptake inhibitor (SSRI) Prozac (fluoxetine)
  • The atypical antidepressant Wellbutrin (bupropion)

As an SSRI, Prozac (fluoxetine) increases the levels of serotonin in the brain. SSRIs are generally the first-line treatment for depression.

Wellbutrin (bupropion) is an antidepressant that doesn't change serotonin levels in the brain. Rather, it uniquely alters other brain chemicals like noradrenaline and dopamine and is associated not only with weight loss but also improved sexual functioning.

This all being said, Wellbutrin may not be appropriate for all people, especially those with a history of seizures or an eating disorder like anorexia or bulimia, which could put you at greater risk for having a seizure while using it.

Like all antidepressants, Wellbutrin and Prozac carry a black box warning regarding their potential for increased risk of suicidal thoughts and actions in children, teens, and young adults during the early stages of treatment.

Proceeding With an Antidepressant

Treating your depression is paramount to your mental health and well-being. Of course, your physical appearance and health are also important, and your doctor would not want weight gain to affect your adherence to your depression therapy.

Have a candid discussion with your doctor about depression treatment as there are a lot of options out there. It's important to remember, too, that weight gain is not inevitable with antidepressant therapy, and if it does occur, it's usually temporary.

A Word From Verywell

Treating your depression may take some patience and resilience on your part as you navigate and find the right plan, but it can be done.

You can optimize both your physical and mental health—in fact, they often feed off one another. Be kind to yourself—you deserve it. 

Sources:

Hirsch M, Birnbaum RJ. Selective Serotonin Reuptake Inhibitors: Pharmacology, Administration, and Side Effects. UpToDate. Updated January 31, 2018.

Patel K, Allen S, Haque MN, Angelescu I, Baumeister D, Tracy DK. Bupropion: a Systematic Review and Meta-Analysis of Effectiveness as an Antidepressant. Therapeutic Advances in Psychopharmacology. 2016;6(2):99-144. doi:10.1177/2045125316629071.

Serretti A, Mandelli L. Antidepressants and Body Weight: A Comprehensive Review and Meta-Analysis. The Journal of Clinical Psychiatry. October 2010;71(10):1259-72. doi:10.4088/JCP.09r05346blu.

Vieweg WV. Psychotropic Drug Considerations in Depressed Patients With Metabolic Disturbances. The American Journal of Medicine. August 2008;121(8):647-55.