The problem of weight gain while taking antidepressants is a big and much discussed problem. There are many Internet forums in which those affected report about it and hope for advice and help from “fellow sufferers”.
With some of the preparations, weight gain is known to be a side effect, with others such a change does not occur or rather the opposite occurs with such - the weight loss.
Both tri- and tetracyclic antidepressants it comes through the Inhibition of certain receptors to a Increase in appetite and thus automatically to weight gain if this is not counteracted.
Especially at Amitripytiline, Clomipramine, Doxepin, Imipramine and trimipramine this is a very common side effect.
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Even with the alpha-2 antagonists It comes to increased appetite and Increase in body weight. This is seen more often with mirtazapine than with mianserin.
MAO inhibitors make up the group of antidepressants that does not affect body weight to have. It should be noted, however, that MAO inhibitors second choice only are.
Both selective serotonin reuptake inhibitors (SSRI) and Serotonin- and noradernal reuptake inhibitors (SNRI) it comes, however more likely to lead to weight lossbecause they increase by increased activation of certain central receptors Loss of appetite and thus to one Weight reduction to lead.
Fluoxetine is a selective serotonin reuptake inhibitor (SSRI). This active ingredient leads to an increase in the serotonin level in the central nervous system, which has a mood-enhancing effect. Compared to the tricyclic antidepressants that have been used for a long time, the SSRIs are characterized by a greater therapeutic range (lower risk of massive side effects in the event of overdose) and a smaller spectrum of side effects. Frequent side effects are sexual dysfunction (loss of libido) and complaints in the gastrointestinal tract (nausea, vomiting). At the beginning of therapy, the increased serotonin level can also lead to an increased sense of fear.
$config[ads_text2] not foundLike fluoxetine, citalopram belongs to the group of selective serotonin reuptake inhibitors (SSRIs). The mood-enhancing effects of the drug are due to an increase in serotonin levels in the central nervous system.
Like fluoxetine, citalopram is also characterized by a greater therapeutic range and a lower spectrum of side effects compared to the tricyclic antidepressants. Instead, sexual dysfunction (loss of libido, erectile dysfunction) and complaints in the gastrointestinal tract (nausea, vomiting) are common.
Valdoxan is a new generation antidepressant with the active ingredient agomelatine. Valdoxan leads to increased noradrenaline and dopamine levels in the central nervous system via mechanisms that have not yet been fully understood.
At the same time, an improvement in the deep sleep phases leads to a better quality of sleep. The typical side effects of antidepressants (loss of libido, erectile dysfunction, weight gain) rarely occur during treatment with Valdoxan. Instead, there is severe damage to the liver, which is why the use of Valdoxan is not allowed in patients with impaired liver function.
The most effective sleep-inducing antidepressant is mirtazapine. It is therefore often used in patients who have severe sleep disorders in addition to depression. However, in the course of therapy with mirtazapine, there is continuous weight gain.
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$config[ads_text3] not foundInstead, some of the newer generation of antidepressants have a sleep-inducing effect without causing weight gain.
In addition to trazodone and nefazodone, Valdoxan (active ingredient: agomelatine) supports sleep in particular. However, the effectiveness of the individual drugs varies from patient to patient. Often an individual decision has to be made with the attending physician as to which medication to use to treat depression with accompanying sleep disorders.
In addition, some antidepressants can have symptoms of fatigue as a possible side effect. Treatment with SSRIs in particular leads to increased tiredness at the beginning of therapy, although a simultaneous sleep-promoting effect is very rare.
Nevertheless, in rare cases, therapy with SSRIs may be indicated for the treatment of depression with accompanying sleep disorders.
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Weight gain under antidepressant therapy is not just an undesirable effect, but also means a additional problem.
Because the "problem with weight" can cause depression amplify.
On the one hand through the weight gain itself, as this often depresses self-esteem.
On the other hand, because the patients do Stop taking the preparation more often or do not take regularly and thus it too no antidepressant effect can come.
At that point a begins Vicious cycle.
A untreated depression often leads to further weight gain, especially in younger patients, as they are in overeating a compensation search.
In the event of weight gain, the patient and the attending physician should, for example, share a Change of antidepressant decide. A Diet change / adjustment and weight-reducing drugs be.
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Treatment with antidepressants without weight gain can often lead to a loss of sexual desire (libido). Both the selective serotonin reuptake inhibitors (SSRIs) and the selective serotonin norepinephrine reuptake inhibitors (SSNRIs) are characterized by this undesirable effect. The aetiology of this sexual dysfunction has not yet been conclusively clarified. Symptoms can occur even after a short period of use.
Patients have decreased sexual desire. It is also difficult for them to cause or maintain an erection. Patients also report sustained erections or premature orgasms. Cases of complete impotence could only rarely be observed.
The side effects may persist for months or years after stopping the antidepressant. Patients rarely report permanent sexual dysfunction.
Symptoms of tiredness occur more frequently at the beginning of therapy with SSRIs. These usually subside in the course of treatment, as the drug then unfolds its drive-enhancing effect.
In addition to persistent fatigue, patients often report sleep disorders and a general malaise. In order to reduce sleep disorders, it is therefore recommended to take the medication in the morning.
Some of the symptoms of fatigue can also arise from an interaction of the SSRIs with other medications.
Given these conditions of unwanted weight gain, the individual decision must also be made as to which preparation best suits the patient.
In the case of already underweight patients, a preparation that shows an appetite-increasing effect should therefore be considered.
