Drugs that cause weight gain
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Drugs That Cause Weight Gain: A Comprehensive Overview
Introduction to Drug-Induced Weight Gain
Weight gain is a common side effect of various medications, particularly those used in psychotropic therapy. This adverse effect can lead to noncompliance with treatment and exacerbate comorbid conditions related to obesity, such as diabetes and cardiovascular diseases1 2 3. Understanding which drugs are associated with weight gain and the mechanisms behind this can help in making informed treatment decisions.
Antidepressants and Weight Gain
Tricyclic Antidepressants (TCAs) and Mirtazapine
Among antidepressants, tricyclic antidepressants (TCAs) like amitriptyline and mirtazapine are frequently associated with significant weight gain. This is thought to be due to their ability to block histaminergic, adrenergic, and cholinergic receptors, which can increase appetite and alter metabolic rates1 4 5. Studies have shown that amitriptyline and mirtazapine can lead to substantial weight gain over the course of treatment1 2 4.
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs, such as paroxetine, have also been linked to weight gain, although the effect is generally less pronounced compared to TCAs. Interestingly, some SSRIs like fluoxetine may initially cause weight loss, but this effect is often transient and may reverse with prolonged use1 4 5.
Antipsychotics and Weight Gain
Atypical Antipsychotics
Atypical antipsychotics, including olanzapine, quetiapine, and risperidone, are well-documented for their propensity to cause weight gain. These medications can lead to significant increases in body weight, which is a major concern for long-term treatment adherence and metabolic health2 3 4 6. The weight gain associated with these drugs is often due to their impact on neurotransmitter systems that regulate appetite and metabolism5 10.
Mechanisms of Weight Gain
The weight gain induced by antipsychotics is believed to be linked to their effects on lipid metabolism and the expression of genes involved in lipid biosynthesis. For instance, quetiapine has been shown to increase the expression of SREBF1 and SREBF2, transcription factors that regulate lipid metabolism, thereby contributing to weight gain and metabolic disturbances10.
Mood Stabilizers and Weight Gain
Mood stabilizers such as lithium and valproic acid are also associated with weight gain. These drugs can lead to significant increases in body weight, which can be problematic for patients with bipolar disorder or other mood disorders3 4 7. The mechanisms behind this weight gain are not fully understood but may involve alterations in metabolic rates and appetite regulation7.
Antiepileptic Drugs and Weight Gain
Certain antiepileptic drugs (AEDs), including valproate and carbamazepine, are known to promote weight gain. Conversely, some AEDs like topiramate and zonisamide may induce weight loss, highlighting the variability in weight effects within this drug class2 8.
Diabetes Medications and Weight Gain
Insulin and Insulin Secretagogues
Improved glycemic control achieved through insulin therapy or insulin secretagogues is often accompanied by weight gain. This is a significant side effect as it can worsen glucose control and increase the risk of cardiovascular diseases7 9.
Thiazolidinediones
Thiazolidinediones, such as pioglitazone, are also associated with weight gain. This class of drugs can lead to increases in body weight, which may counteract their benefits in managing blood sugar levels2.
Conclusion
Weight gain is a significant side effect of many commonly prescribed medications, particularly those used in psychotropic and diabetes therapies. Understanding the specific drugs and their mechanisms can help healthcare providers make better treatment choices and implement strategies to mitigate this adverse effect. Monitoring and managing weight gain through dietary counseling, physical activity, and careful drug selection are essential to improve patient outcomes and adherence to therapy.
Sources and full results
Most relevant research papers on this topic
Antidepressants and body weight: a comprehensive review and meta-analysis.
Antidepressants may cause weight gain or weight loss, with amitriptyline, mirtazapine, and paroxetine being more likely to cause weight gain, while fluoxetine and bupropion may cause weight loss.
Meta-Analysis
Highly CitedClinical review: Drugs commonly associated with weight change: a systematic review and meta-analysis.
Several drugs are associated with weight change, guiding drug choice and preemptive weight loss strategies when obesogenic drugs are prescribed.
Meta-Analysis
Rigorous JournalHighly CitedWeight gain associated with use of psychotropic medications.
Preventing weight gain is crucial, and addressing it as soon as it occurs is crucial for effective treatment and long-term outcomes.
Highly CitedBody weight changes associated with psychopharmacology.
Psychopharmaceuticals can cause weight gain or loss, and careful monitoring and consideration of alternative therapies are essential for managing these weight changes.
Systematic ReviewHighly CitedH1-histamine receptor affinity predicts weight gain with antidepressants
Antidepressants with H1-histamine receptor affinity are the strongest predictor of weight gain, suggesting a need for pharmacodynamic classification and avoidance in patients at risk for cardio-metabolic disturbances.
Meta-AnalysisMedications Associated with Weight Gain
Commonly prescribed medicines can cause significant weight gain, with wide interindividual variation in response and degree of weight gain within drug classes.
Systematic ReviewHighly Cited[Psychotropic drugs induced weight gain: a review of the literature concerning epidemiological data, mechanisms and management].
Psychotropic drugs can cause weight gain, increase health risks, and require management strategies such as drug switching, dietary changes, and increased physical activity.
Literature ReviewDrug-induced weight gain
Drug-induced weight gain can lead to noncompliance with therapy and worsen comorbid conditions related to obesity.
Bodyweight Change as an Adverse Effect of Drug Treatment
Drug treatment can cause bodyweight changes, affecting patient compliance and potentially posing health risks.
Highly CitedBiological Mechanism(s) Underpinning the Association between Antipsychotic Drugs and Weight Gain
Antipsychotic drugs may cause weight gain by regulating lipid metabolism, potentially impacting white matter structure and influencing the risk of weight gain and metabolic syndrome.
In Vitro StudyRigorous Journal