Escitalopram (
Lexapro) - An active isomer of citalopram (Celexa) which both belong to a class of
antidepressants known as Selective
serotonin reuptake inhibitors (
SSRIs).
SSRIs are not likely to cause weight gain if used for 6 months or less.
Opinions vary as to whether they cause weight gain when used for 1 year or longer. Paroxetine (Paxil) may be more likely than other
SSRIs to cause weight gain.[2]
In its revised practice guideline for the treatment of major depressive disorder,[1] the American Psychiatric Association acknowledges that the literature differs as to whether patients taking
SSRIs beyond the acute phase experience weight gain as a medication side effect.[1]
Fighting weight gain once it has occurred can be very difficult, and it is advisable to consider the likelihood and potential consequences of weight gain when choosing an
antidepressant.[2,3]
It has been found that adding low-dose bupropion (Wellbutrin) (100 to 150 mg/day) or topiramate (25 to 50 mg/day) may help weight loss when used in addition to diet control and exercise.[4] In general, bupropion (Wellbutrin) is more likely to cause weight loss.
Please discuss these options with your psychiatrist.
References:
===========
1. American Psychiatric Association. Practice guideline for the treatment of patients with major depressive disorder (revision). Am J Psychiatry 2000; 157(suppl 4):1–45.
2. Zajecka JM. Clinical issues in long term treatment with
antidepressants. J Clin Psychiatry 2000; 61 (suppl 2):20–25.
3. Masand PS. Weight gain associated with psychotropic drugs. Review. Expert Opinion on Pharmacotherapy 2000; 1:377–389.
4. Rashmi Deshmukh, Kathleen Franco. Managing weight gain as a side effect of
antidepressant therapy. Cleveland Clinic Journal of Medicine 2003; Vol. 70.
Dr. Tamer Fouad, MD
MB, BCh, MSc Internal Medicine.
Consultant of Hematology - Oncology.
