Medicines that cause weight gain
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Medicines That Cause Weight Gain: A Comprehensive Review
Introduction to Drug-Induced Weight Gain
Weight gain is a common and significant side effect associated with various medications. This adverse effect can lead to noncompliance with therapy, exacerbation of comorbid conditions, and increased health risks such as obesity, diabetes, and cardiovascular diseases1 2 3. Understanding which medications are likely to cause weight gain and the mechanisms behind this can help in making informed treatment decisions.
Psychotropic Medications and Weight Gain
Antipsychotics
Antipsychotic medications, particularly second-generation antipsychotics, are well-documented for their propensity to cause weight gain. Drugs such as clozapine and olanzapine are associated with significant weight increases, with clozapine leading to an average weight gain of 4.45 kg and olanzapine 4.15 kg over a 10-week period10. Other antipsychotics like risperidone and quetiapine also contribute to weight gain, though to a lesser extent4 9. The weight gain associated with these medications can be dose-dependent, with some drugs showing a plateau effect at higher doses6.
Antidepressants
Antidepressants, particularly tricyclic antidepressants (TCAs) and certain selective serotonin reuptake inhibitors (SSRIs), are also linked to weight gain. Amitriptyline, a TCA, and mirtazapine, an atypical antidepressant, are notable for their higher risk of inducing weight gain3 4. Conversely, some SSRIs like fluoxetine may initially cause weight loss but can lead to weight gain with long-term use3 7.
Mood Stabilizers
Mood stabilizers such as lithium and valproic acid are known to cause significant weight gain. Lithium, in particular, can lead to substantial increases in body weight, which can be problematic for long-term management of conditions like bipolar disorder5 8.
Neurological Medications
Antiepileptics
Certain antiepileptic drugs (AEDs) are associated with weight gain. Valproate and carbamazepine are among the AEDs that can lead to significant weight increases8. However, some AEDs like topiramate and zonisamide may induce weight loss, offering alternative options for patients concerned about weight gain4.
Diabetes Medications
Insulin and Insulin Secretagogues
Improved glycemic control achieved through insulin therapy or insulin secretagogues often comes with the side effect of weight gain. This is a significant concern as it can worsen glucose control and increase cardiovascular risks7. Thiazolidinediones, another class of diabetes medications, are also associated with weight gain4.
Sulfonylureas
Sulfonylureas, including drugs like glimepiride and glyburide, are linked to weight gain. These medications can lead to increases in body weight ranging from 1.8 kg to 2.6 kg4.
Mechanisms Behind Drug-Induced Weight Gain
The mechanisms by which these medications cause weight gain are complex and multifaceted. Many psychotropic drugs interfere with neurotransmitter systems that regulate appetite and energy balance, leading to increased food intake and reduced metabolic rate5 7. For instance, antipsychotics may affect the hypothalamic pathways involved in hunger and satiety, while antidepressants might alter serotonin and norepinephrine levels, influencing appetite9.
Management and Prevention
Preventing and managing drug-induced weight gain involves several strategies. These include selecting alternative medications with a lower risk of weight gain, providing dietary counseling, and encouraging physical activity2 7. In some cases, adjunctive therapies like metformin may be used to mitigate weight gain associated with diabetes medications7.
Conclusion
Weight gain is a significant side effect of many commonly prescribed medications, particularly psychotropic and diabetes drugs. Understanding the specific medications that cause weight gain and the underlying mechanisms can help healthcare providers make better treatment choices and manage this adverse effect more effectively. By considering alternative therapies and implementing preventive measures, the impact of drug-induced weight gain can be minimized, improving patient compliance and overall health outcomes.
Sources and full results
Most relevant research papers on this topic
Medications 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 Review
Highly 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 CitedAntidepressants 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-AnalysisHighly 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.
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Drug treatment can cause bodyweight changes, affecting patient compliance and potentially posing health risks.
Highly CitedAntipsychotic-Induced Weight Gain: Dose-Response Meta-Analysis of Randomized Controlled Trials.
Second-generation antipsychotics differ in their propensity to produce weight gain and the shapes of their dose-response curves, which are important for dosing decisions in clinical practice.
Meta-AnalysisRigorous Journal[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.
Epidemiology, implications and mechanisms underlying drug-induced weight gain in psychiatric patients.
Drug-induced weight gain in psychiatric patients is common and often leads to obesity, with some drugs causing weight gain and others reducing weight.
Literature ReviewHighly CitedAntipsychotic-induced weight gain: a comprehensive research synthesis.
Both conventional and newer antipsychotics cause weight gain, with clozapine having the greatest potential for weight gain and ziprasidone the least.
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