Around 14% of US adults report using antidepressants in the US, making them one of the most widely-used drug classes. Although weight gain is a known side effect, until now, evidence on comparative weight change for first-line antidepressant treatments has been limited.
In the current study, researchers compared weight change across eight first-line antidepressant treatments: sertraline, citalopram, escitalopram, fluoxetine, paroxetine, bupropion, duloxetine, and venlafaxine. To do so, they analyzed electronic health record prescription data from eight health systems in the US, including 183, 118 adults aged between 18-80 years old who were new to antidepressants. They then compared participants’ weight at 6, 12 and 24 months after initiating treatment.
Ultimately, they found that users of bupropion gained the least amount of weight relative to users of other antidepressants. Meanwhile, escitalopram and paroxetine were linked to an approximately 15% higher risk of clinically significant weight gain than sertraline in the first six months. Sertraline, escitalopram, and paroxetine are all selective serotonin reuptake inhibitors (SSRI), the most common type of antidepressant. Clinically significant weight gain was defined as 5% or more of baseline weight six months after starting treatment.
“Although there are several reasons why patients and their clinicians might choose one antidepressant over another, weight gain is an important side effect that often leads to patients stopping their medication,” said senior author Jason Block, a general internal medicine physician and Harvard Medical School associate professor of population medicine, in a press release.
“Our study found that some antidepressants, like bupropion, are associated with less weight gain than others. Patients and their clinicians could consider weight gain as one reason for choosing a medication that best fits their needs," he added.
Sources: EurekAlert, Annals of Internal Medicine