Weight gain after starting treatment with antidepressants isn’t likely to vary much depending on the drug, according to a report published on Monday in Annals of Internal Medicine.
Among the eight antidepressants studied, bupropion (Wellbutrin) was consistently associated with the least weight gain, researchers said.
However, only small differences in weight changes were likely among patients taking any of the drugs, they said.
The researchers emulated a randomized trial to compare the drugs using health records of more than 183,000 adults who were starting treatment with either bupropion, sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), venlafaxine (Effexor), paroxetine (Paxil), or duloxetine (Cymbalta).
Zoloft – the most commonly prescribed first-line drug used by 20% of participants – was associated with an average gain of nearly 0.5 pounds (0.2 kilograms) after six months.
Users of Lexapro, Paxil and Cymbalta gained an average of 0.7 to 0.9 pounds (0.3 to 0.4 kilograms) more than those on Zoloft after 6 months, and were 10% to 15% more likely to have gained at least 5% of their baseline weight.
Wellbutrin users gained about half a pound less on average than Zoloft users, and they were 15% less likely to gain at least 5% of their baseline weight.
The effect of Prozac use on weight change was similar to that of Zoloft.
“Clinicians and patients could consider these differences when making decisions about specific antidepressants, especially given the complex relationships of obesity and depression with health, quality of life, and stigma,” the researchers said.
