Do Antidepressants Like Lexapro Cause Weight Gain?
Key takeaways:
Paxil (paroxetine), Remeron (mirtazapine), and amitriptyline are more likely to cause weight gain than other antidepressants. Most selective serotonin reuptake inhibitors (SSRIs), such as Lexapro (escitalopram), are associated with a weight increase if you take them long-term.
Antidepressants that are least likely to cause weight gain include Wellbutrin (bupropion). Viibryd (vilazodone), and fluvoxamine. Trintellix (vortioxetine) and Pristiq (desvenlafaxine) are also considered weight-neutral medications.
Keep in mind that everyone responds differently to medication. You shouldn’t stop taking your antidepressant on your own if it’s affecting your weight. Instead, work with your healthcare team to find a treatment plan that best fits your needs.
Depression is one of the most common mental health conditions worldwide. It affected about 8% of U.S. adults in 2021. Depression treatment may involve psychotherapy or medications. Many people benefit from receiving both.
But the side effects of antidepressants may stop some people from seeking treatment. One concern may be the potential for antidepressants to cause weight gain. But is Lexapro or Prozac really to blame for those extra pounds? Here, we’ll cover what you need to know about antidepressants and weight gain.
Do all antidepressants cause weight gain?
It’s possible for most antidepressants to cause weight gain, but some are more likely to cause it than others.
Keep in mind that not everyone taking an antidepressant will gain weight. Overall, studies show that about 10% to 20% of people taking antidepressants gain weight. And the average weight gain while taking antidepressants ranges from about 2 lbs to 7 lbs.
It’s likely that you’ll be able to find an antidepressant that helps your symptoms with little effect on your weight. It just might take a little trial and error to find the right fit.
Which antidepressants are commonly linked to weight gain?
As a class, tricyclic antidepressants (TCAs) are most likely to cause weight gain. Amitriptyline seems to be the biggest culprit within this class.
Remeron (mirtazapine) is another antidepressant that’s more likely to cause weight gain. It’s a tetracyclic antidepressant that works in a similar way to TCAs in the body.
Paxil (paroxetine) is a selective serotonin reuptake inhibitor (SSRI) that’s connected to weight gain both short-term and long-term. Most other SSRIs are only linked to weight gain with long-term use (more than 6 months).
Antidepressant guide: Learn more about the common types of antidepressants and how they compare.
Dietary tips: Here’s how to create and maintain a healthy eating plan to support your health.
Exercise and depression: Explore the mental health benefits of regular exercise and some tips to help you get moving.
Cymbalta (duloxetine) is a serotonin and norepinephrine reuptake inhibitor (SNRI). It’s more likely to cause weight loss with short-term use, but can lead to weight gain with long-term use.
The table below summarizes common antidepressants and their usual effect on body weight. Keep in mind that everyone responds to medication differently. Your experience may differ from what’s described below.
Which antidepressants are the least likely to cause weight gain?
Wellbutrin (bupropion) is an antidepressant that’s least likely to cause weight gain. In fact, it’s often associated with weight loss in people who take it. So it’s often a preferred option for those looking to avoid weight gain from their depression medication.
Pristiq (desvenlafaxine) is a weight-neutral SNRI for most people. This seems to hold true for both short- and long-term use.
Prozac (fluoxetine) is an SSRI that typically causes weight loss with short-term use (less than 6 months). Lexapro (escitalopram), Zoloft (sertraline), and most other SSRIs are less likely to cause weight gain if you take them for a short period of time (6 months or less).
Fluvoxamine is one SSRI that seems to be weight neutral. It hasn’t been associated with weight changes after short or long-term use for most people. Viibryd (vilazodone) is another weight-neutral antidepressant that works similarly to SSRIs in the body.
Trintellix (vortioxetine) is also considered weight neutral. Minimal weight changes were reported after 1 year of treatment in clinical studies.
Why do some antidepressants cause weight gain?
Each type of antidepressant acts on different chemicals and receptors (binding sites) in the body to improve your mood. But some of these effects can also change the way your body responds to food.
Medications that block histamine receptors can lead to weight gain. You may recognize histamine as a chemical that causes allergy symptoms. But it also helps you control your appetite. Blocking it may increase your craving for carbs and make you feel less full than usual, leading you to eat more. TCAs are most often associated with these effects.
Other antidepressants block a certain type of serotonin receptor that controls how much you eat. And some also increase levels of serotonin in the body, which can make you want to eat more than usual. These effects are often associated with SSRIs.
It’s also possible that weight gain from antidepressants may not actually be caused by the medication itself. Depression can cause a decreased appetite in some people. It can also make you feel less motivated to exercise, which can cause muscle loss.
Once your antidepressant starts to work, your appetite may return to normal. And you may start feeling more motivated to exercise and rebuild any muscle you’ve lost. Both of these changes can lead to weight gain. But they’re also often a sign that your depression symptoms are improving.
How can you manage or prevent weight gain from antidepressants?
If you’re living with depression, lifestyle changes can go a long way to help improve your symptoms and manage your weight at the same time. Regular exercise can help prevent weight gain and lift your mood. And a balanced diet that’s low in processed foods can keep your body fueled and running at its best.
If weight gain is a concern for you, discuss it with your prescriber before you start taking an antidepressant. They can help you choose an option that’s less likely to cause weight gain. If you’ve already started taking an antidepressant and you notice a change in your weight, let your prescriber know. They may want to change your depression medication. Or they may suggest adding a weight-loss medication if it’s appropriate for you.
Good to know: You shouldn’t stop taking your antidepressant without talking to your prescriber first. Many depression medications can cause harmful withdrawal symptoms if you stop taking them suddenly. Your prescriber can help you stop taking your medication safely, or give you directions for switching to a different medication if needed.
Frequently asked questions
Can you lose weight while on antidepressants?
Yes, you can lose weight while taking antidepressants. As your mood improves, you may feel more able to incorporate regular exercise and healthy nutrition into your routine. And some antidepressants, such as Wellbutrin, may help you lose weight along with improving your mood. The best way to maintain a healthy weight is to work with your healthcare team to find the right balance of consistent lifestyle changes and medications for your needs.
Does Zoloft cause weight gain or loss?
Zoloft is an SSRI that may cause weight gain for some people. Keep in mind that just because weight gain is possible with Zoloft doesn’t mean it will happen to everyone who takes it. Taking Zoloft short-term isn’t likely to affect your weight. And weight gain with Zoloft seems to be less significant than with some other antidepressants, such as Lexapro and Paxil. Children taking Zoloft are more likely to experience weight loss. So your pediatrician will likely keep an eye on their growth and development during treatment.
Do antidepressants slow metabolism?
Probably not. Your metabolism is a fixed rate that’s based on your age, sex, and body composition. There’s not much you can do to change it. The weight gain caused by antidepressants likely has more to do with how the medications affect hormones and other chemicals in the brain that control your appetite and food cravings. That being said, exercising regularly and sticking to a healthy diet can help support a healthy weight (and metabolism) while you’re taking an antidepressant.
The bottom line
Paxil (paroxetine), Remeron (mirtazapine), and amitriptyline are antidepressants that are more likely to cause weight gain in people who take them. Lexapro (escitalopram) and most other selective serotonin reuptake inhibitors (SSRIs) are more likely to cause weight gain if you take them long term.
Fluvoxamine and Viibryd (vilazodone) aren’t likely to affect your weight with short or long-term use. Trintellix (vortioxetine) and Pristiq (desvenlafaxine) are also considered weight-neutral antidepressants. Wellbutrin (bupropion) is more likely to cause weight loss than other antidepressants.
Keep in mind that everyone responds to medication differently. But if you experience unwanted weight gain while taking an antidepressant, don’t stop taking your antidepressant on your own. Talk with your healthcare team about your options. They can help you safely change your medication if needed to one that’s less likely to affect your weight.
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For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
