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How do you counsel patients when they ask whether the SSRI or SNRI antidepressant you have recommended will result in weight gain?

Have you found significant differences among SSRIs and SNRIs (e.g., paroxetine vs. fluoxetine vs. sertraline vs. escitalopram vs. duloxetine)? What data do you direct patients to regarding this question?
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What antidepressant have you found to cause the most weight gain?

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3 Answers
Mednet Member
Mednet Member
Psychiatry · Massachusetts General Hospital/Harvard Medical School
Answered on

This recent study on antidepressant-associated weight gain has generated a lot of interest and press, and can be a helpful starting point: Petimar et al., PMID 38950403.

As with all studies, it has its limitations, but highlights that many people will experience minimal-modest weight change on antide...

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Mednet Member
Mednet Member
Psychiatry · Morin Charles R Office
Answered on

Bupropion doesn't cause weight gain, fatigue, or apathy. A lot of people in the past failed a trial of bupropion because, back then, it was a twice-daily dosing so many people forgot the second dose. Now that it's once-daily dosing it would be my first choice (plus it's a lot cheaper than the newer ...

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Mednet Member
Mednet Member
Psychiatry · Private Practice, General Psychiatry
Answered on

I inform patients that antidepressants may or may not cause weight gain. If it turns out that the one that's prescribed for them does this, then (I tell them) it is not acceptable, and I will prescribe a medicine to counteract weight gain, or we will switch to another antidepressant.

I agree that b...

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