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According to the National Institute of Mental Health, approximately 18.8 million Americans suffer from a depressive disorder each year, and 12.4 million of these are women. Within the past 10 years, the arsenal of weapons used to combat depression has increased but has made antidepressant induced weight gain a factor. In addition to tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs), there are now selective serotonin reuptake inhibitors (SSRIs) and other medications (such as buproprion) that cannot be lumped into any of those categories, but make up their own special group. Like any medication, antidepressants have side effects, and aside from the usual and somewhat mild complaints of shakiness, insomnia, dizziness, etc, the side effect that could potentially exacerbate a depressive episode, especially in a woman, is weight gain. Unfortunately, antidepressant induced weight gain has become a major side effect.
Tricyclics and SSRIs seem to be the biggest culprits in antidepressant induced weight gain. Studies have shown that tricyclic antidepressants may increase a person's craving for carbohydrates, and while some carbohydrates are good (ie, multigrain breads, brown rice, etc), depressed women will be more prone to eat candy, cookies, cakes, white bread, and pasta. When so many carbohydrates are consumed, blood glucose levels peak rapidly and then fall, fueling the body's craving for more of the same. And the cycle continues. (Chocolate, of course, is another carbohydrate that naturally, if briefly, corrects the loss of serotonin sometimes experienced during states of depression. And we all know how most women feel about chocolate.)
Obviously, antidepressant induced weight gain is not the cause of the current epidemic of overweight (and obesity) that reigns in the United States. Approximately 46.9 million women in the United States that are 20 years and older are overweight, and the predominant cause of this is not because women take antidepressants that may or may not physiologically encourage them to eat more bagels and chocolate éclairs. But if a women of a normal weight begins taking an antidepressant and suddenly finds within several months that's she's gained at least 5 pounds, more often than not she will feel worse about herself, blame the medication, and then decide to stop taking it, defeating the ultimate purpose of the antidepressant. In some instances, antidepressant induced weight gain may be a good thing if a woman's depressive episode has caused her to lose weight. The medication may pull her out of a downward slump in which she has forgone eating (and probably other activities) because she has felt so bad.
But what about antidepressant induced weight gain on a woman who is already a little or more overweight than is considered normal? If this woman, who already may have a problem with food (as is the case with many depressed women: eating too much, eating too little), gains even more weight as the result of taking an antidepressant, she may initially feel better within that first few weeks, but eventually as more weight is packed on, she could be back emotionally where she was before starting the medicine. And because of the cycle of emotionally-fueled weight gain, she could potentially be placing herself at an even higher risk for the co morbidities associated with being overweight: cardiovascular disease, diabetes, and joint problems.
Although depression is considered a medical problem because of its maladjustment of the brain's neurotransmitters (norepinephrine, serotonin, and dopamine), its symptoms take a more visible toll on the physical body. Antidepressant induced weight gain may be the most serious because it leads to many other physical problems.
Studies have been conducted on patients who took Paxil, Zoloft, and Prozac (SSRIs) for a year or longer, and they have shown that for the most part, a modest number of patients gain more than 7% of their baseline weight. This may not be a startling percentage, but it is cause for concern. For patients who are already overweight, this poses an even bigger problem, physically and psychologically. For patients who are of normal weight, extra weight gain may not be a serious cause for emotional or physical concern. But because it may exacerbate a woman's depression, antidepressant induced weight gain as a potential side effect should be taken into consideration when antidepressant treatment is started.
For more on the subject of antidepressant induced weight gain click here.
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