Weight changes with common Antidepressants

Boston, MA – A new study finds that bupropion users are 15-20% less likely to gain significant weight compared to sertraline users. The findings are published in the Annals of Internal Medicine on July 2.

Antidepressants are widely prescribed in the U.S., with 14% of adults using them. Weight gain is a common side effect that can impact long-term health and lead to the cessation of medication. Different antidepressants affect weight differently.

Researchers from the Harvard Pilgrim Health Care Institute identified which common antidepressants are linked to the most and most minor weight gain. Lead author Joshua Petimar noted that this real-world evidence helps patients and clinicians make informed decisions when choosing an antidepressant.

Researchers analyzed prescription data from eight U.S. health systems in PCORnet, involving 183,118 adults aged 18-80 starting antidepressants. Though rigorous, randomized control trials are costly and time-consuming.

Instead, the team simulated a trial by designing an ideal study and aligning data to match it closely. They compared weight changes over 6, 12, and 24 months for eight common antidepressants: sertraline, citalopram, escitalopram, fluoxetine, paroxetine, bupropion, duloxetine, and venlafaxine.

In the study, bupropion users gained the least weight compared to other antidepressants. They were 15-20% less likely to gain a significant amount of weight than those taking sertraline, a common antidepressant.

The researchers defined substantial weight gain as 5% or more. They also found that some medications in the same class or subclass as sertraline, such as escitalopram and paroxetine, were associated with around 15% higher risk of significant weight gain in the first six months.

Senior author Jason Block emphasized that weight gain is a crucial side effect affecting medication adherence. Choosing an antidepressant-like bupropion, associated with less weight gain, could be a consideration for patients and clinicians.

In conclusion, the study revealed that bupropion users tend to experience less weight gain compared to users of other common antidepressants like sertraline. This finding underscores the importance of considering potential side effects, such as weight gain, when selecting antidepressant medications aiming to improve patient adherence and overall treatment outcomes.

Journal reference:

Joshua Petimar,  Jessica G. Young et al ., Medication-Induced Weight Change Across Common Antidepressant Treatments: A Target Trial Emulation Study. Annals of Internal Medicine. DOI: 10.7326/M23-2742.

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