Antidepressants and Weight Gain

Written by Alaina Bodi, a Mayo Clinic dietetic intern 

One common side effect experienced by people taking antidepressants is weight gain.  This happens for a variety of reasons, including fluid retention, lack of exercise, and improved appetite as depression symptoms subside.  Some medications are more likely to cause weight gain than others, including:

• Amitriptyline, imipramine (Tofranil), doxepin, and other tricyclic antidepressants
• Phenelzine (Nardil), and some other monoamino oxidase inhibitors (MAOIs)
• Paroxetine (Paxil, Pexeva), a selective serotonin reuptake inhibitor (SSRI)
• Mirtazapine (Remeron)

Weight gain after starting an antidepressant isn’t always related to the medication.  Other factors can lead to gaining weight, such as overeating or inactivity due to depression symptoms or normal weight gain with age, regardless of medication usage.  There are strategies you can use to prevent weight gain or lose weight you have gained, including:

• Consuming less sweets and sugar-sweetened beverages
• Selecting lower-calorie snacks, like fruits or vegetables with a low-fat dipping sauce
• Regularly participating in physical activity or exercise throughout the week

It’s important to remember that not everyone will experience weight gain while taking antidepressants and discuss any concerns you have about side effects associated with your medication with your doctor.  If you do gain weight after starting an antidepressant medication, discuss the pros and cons of your medication with your doctor.  Together, you may decide that the benefits of the medication outweigh the weight gain, or you may decide to adjust your dose or trial a different medication.  If you do decide to continue your current medication regimen, consider seeking the advice of a Registered Dietitian, who will be able to provide advice for diet and lifestyle modifications that will help prevent or reverse weight gain.