Can Antidepressants Lead to Weight Gain?

Uma Shankari By Uma Shankari, 18th Jan 2011 | Follow this author | RSS Feed | Short URL
Posted in Wikinut>Health>Drugs & Medicines

The beginnings of obesity epidemic coincides with increasing prescriptions of serotonin-reuptake-inhibiting antidepressants (SSRIs) like Prozac and Paxil since the 80's for even simple behavioral and psychological problems. And this is not coincidental, but very much interconnected.

Stress and depression

We experience many sad, challenging and emotionally shattering experiences in our lives. Be it the loss of job or someone you love, or be it some chronically painful health conditions, everybody faces moments of despair some time or the other.

Depression can also be caused by chronic stress. Our society places so much premium on success that we stress ourselves trying to pack our days with so many activities that we hardly have time to relax and just be. Prolonged stress causes the body to over-produce hormones that impact the health negatively.

The two adrenal glands (“ad” means near; “renal” means kidney) are situated on top of the kidneys, and consist of an inner medulla, which orchestrates your short-term stress response, and an outer cortex, which mediates your adaptation to chronic stress.

The primary hormone of the medulla is epinephrine, also called adrenalin, that is secreted in response to the four E’s: exercise, excitement, embarrassment, and emergency. The flood of adrenaline that is unleashed in these situations makes the heart beat more rapidly and forcefully so that more blood flows to the skeletal muscles, heart, and brain. This is why adrenaline is known as the “fight or flight” hormone.

Adrenaline’s effects are short-lived. On the other hand, cortisol, the stress hormone produced by the outer cortex, lingers longer in the body.

The primary function of cortisol is to promote gluconeogenesis, the conversion of fats and proteins to sugar (glucose). Gluconeogenesis is an essential component of your body’s adaptation to chronic stress, ensuring that your vital organs, especially your brain, heart, and skeletal muscles, have enough energy to meet the increasing workload. In addition, cortisol assists adrenaline in stimulating the cardiovascular system, increasing the heart rate and pumping capacity and temporarily raising blood pressure and decreasing inflammation.

And when chronic stress repeatedly forces the adrenal glands to sustain high levels of cortisol, two things happen: first, the adrenals can’t attend to their broader role in hormonal regulation because the same resources they use to make hormones like estrogen are required to make cortisol, and second, cortisol starts to damage healthy tissues. Eventually, adrenal fatigue sets in, and people, especially women, experience symptoms such as weight gain, insulin resistance, high blood sugar, fatigue, insomnia, fuzzy thinking, depression, cravings and mood swings.

These effects are caused by the brain's inability to produce serotonin, because the high levels of stress hormones deprive the body of sufficient sleep, which is fundamental for the brain to restore its ability to produce serotonin.

Drug companies: monetizing depression

When we are under chronic stress, we almost feel the dark clouds of deep depression would never lift.

But time is a healer. Friends, relatives, community support groups and psychologists help us cope up with such losses. We learn to accept losses and move on. Combating stress lies in accepting what we cannot change.

But such an attitude would not benefit the manufacturers of antidepressants who would want us to believe that depression is a result of chemical imbalances in the brain and can be fixed up easily with drugs.

Is depression always a result of chemical imbalance?

Researchers admit they know very little about what a normal level of serotonin is or how antidepressants work and fix the "abnormal" levels. Many studies contradict the chemical imbalance theory of depression. Experiments have shown that lowering people’s serotonin levels doesn’t always depress mood, nor does it worsen symptoms in people who are already depressed. And while antidepressants raise serotonin levels within hours, it takes weeks – an unexplained lag – for the medication to relieve depression. Serotonin is just one of many factors that plays a role in defining depression. Inflammation, elevated stress hormones, immune system suppression, nutritional deficiencies, sedentary lives and shrinking brain cells – all these and more play a role too. Psychological factors—such as loneliness and low self-esteem are contributory factors as well.

Side effects of antidepressants

When an antidepressant is ingested, the brain and body start to produce extra cortisol and adrenalin. Antidepressants slow the metabolism and inhibit specific enzymes in the liver that allow the metabolism to function correctly. The hormonal changes decrease satiety and increase appetite and carbohydrate cravings. These further add to weight gain.

Here's one such report from psychcentral site: "Clinical depression in itself does not appear to increase the risk of obesity. Treatment of depression with antidepressants medications may be associated with an increased risk of obesity, and strategies to offset this risk may be useful in clinical practice."

There are a number of mechanisms for antidepressant-induced weight gain. Different antidepressants probably cause weight gain through different mechanisms.

There could be central nervous system effect on specific receptors, such as histamine receptors. There could be sedative effects of the antidepressant medication leading to decreased physical activity and caloric expenditure.


Adrenal Fatigue, Antidepressants, Damaging Effects Of Stress, Depression, Gluconeogenesis, High Cortisol, Mood Disorders

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author avatar Uma Shankari
I write on society, relationships, travel, health, nutrition and fitness.
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author avatar Denise O
20th Jan 2011 (#)

Hmmmm, interesting.
Thank you for sharing.:)

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author avatar CHAN LEE PENG
20th Jan 2011 (#)

Important topic worth reading.

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author avatar Artur Victoria
23rd Jan 2011 (#)

Article writing very well structured with a very interesting subject. Thanks

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author avatar David Reinstein,LCSW
19th Jul 2011 (#)

There is no question but that most of the SSRIs and many of the mood stabilizing medicines cause weight gain. Whether or not that is a good reason to not use them should follow some kind of personal cost-benefit analysis.

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author avatar Kingwell
13th Feb 2013 (#)

Interesting post.

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