The only antidepressant that has been associated with a certain amount of long term weight-loss is Bupropion, according to recent study cohort review published not that long ago in the Journal of Clinical Medicine, this only happens among non-smokers.
Research Study Into Bupropion
The conclusion of the Group Health Research Institute was that the only antidepressant which tends to be associated to weight loss over a two year period is Bupropion. Studies have suggested that among the vast majority suffering from depression or dealing with being overweight or obesity, Bupropion is the best initial choice of antidepressant.
With Bupropion, Those who Lost Weight Were Nonsmokers
Over two years, Dr. Arterburn and various colleagues studied the link between weight change and antidepressant choice among adults who had recently been prescribed antidepressant therapy.
Due to the fact that Bupropion (generic name for Wellbutrin) which is a highly prescribed antidepressant is also used as a supplement to smoking cessation, and since smoking cessation is strongly linked to weight gain, what they sought to examine were the effects that this antidepressant had in weight gain among nonsmokers and smokers separately.
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A retrospective electronic cohort study that was health record based was conducted on adult patients who had started second generation monotherapy antidepressant treatment between the year 2005 and 2009. The reference treatment that was used was fluoxetine which included Bupropion, sertraline, mirtazapine, duloxetine, citalopram, paroxetine, trazodone, and venlafaxine.
For potential confounders found at baseline, the researchers made adjustments that included sex, age, bipolar disorder, anxiety disorder, schizophrenia, sleep disorder, smoking status at the onset of the treatment for depression as well as schizoaffective disorders.
The only medication linked to a significant different weight loss estimated at two years in comparison with fluoxetine was Bupropion, this however was only seem in nonsmokers.
After adjustments for confounders were made, nonsmokers who were treated with Bupropion lost around 7.1 pounds when compared to the nonsmokers who were on fluoxetine.
However, in those who smoked the results were different. On average, smokers who were on Bupropion, gained 2.1 pounds when compared with smokers who were on fluoxetine, however this was not a significant difference.
On average, those on mirtazapine gained around 11.6 pounds in comparison with those on fluoxetine. This was not a statistically significant difference, probably due to the mall amount of patients who were given mirtazapine.
The remaining drug weight change estimates with antidepressants, with the exception of sertraline, were not very different from fluoxetine. On average, those who were on sertraline gained 5.9 in comparison with those on fluoxetine.
Commonly, obesity and depression occur together, and an adult with both conditions could have even higher health risks. The causal pathway is most likely bidirectional adults who are obese have a higher risk of suffering from depression and vice versa.
However, it is noted that the use of Bupropion is not ideal for all patients; this includes those that have a history of seizure disorder. Although the effect is limited to nonsmokers, we have found that the only antidepressant linked to long term weight loss if bupropion.
When it comes to improving depressive symptoms there is similar efficacy from Bupropion and other second generation antidepressants, Bupropion may actually be the first line of drug option for patients that are overweight or obese, unless there are contraindications that already exist.
Ample amounts of evidence indicate that there is not a difference in how people moods are improved with the newer antidepressants. This is why it makes sense for doctors and their patients to opt for antidepressants based off of their costs, side effects and the preference of the patient, and now also on whether a patient is overweight or obese.
You can learn more about the study of Bupropion (Wellbutrin) affecting weight loss here: https://www.ncbi.nlm.nih.gov/pubmed/11557835