antidepressants and weight gain ?

Q.What are people's experiences with weight gain or (hopefully) loss on antidepressants? Does trazodone cause weight gain? How often, how soon and how much weight gain? Is it dose related? Is it due to increasing appetite? I know each person is different, but I'd appreciate "real" people's experiences. Does Wellbutrin really cause weight loss? How about the newer SSRIs like Prozac, Paxil, Zoloft, Serzone, Celexa, Luvox and the "hybrid", Effexor? How about the tricyclic antidepressants like amitriptyline and nortriptyline? Has anyone found good websites with more info on these topics? Is tryptophan available now anywhere?

A.I have been on all of the antidepressants you mentioned except Celexa and nortriptyline...I have not been on tryptophan, but I do not believe that is an AD. Anyway, I have never experienced weight gain that I felt was directly attributible to the AD EXCEPT with Elavil (amitriptyline) in which I gained 30 lbs, despite a constant backdrop of my same exercise and diet regimen. I think it is well documented that Elavil can cause this; perhaps also Sinequan (another sedating tricyclic), though I am not sure on the latter. Regrettably, I cannot recall the final sustained doseage or the duration for which I gained all the weight. I have never had a problem with any of the others. However, I should indicate that I have anxiety disorders which make it difficult for me to have much appetite. But with Elavil, I think it did something with my metabolism, whereas the others for me never intrinsically seemed to cause weight gain...if I did gain weight on any of the others it was due to a behavior change(e.g. less exercise, usually) rather than metabolism. I'm not sure. I do know that some meds have the effect of increasing activity and reducing sleep ...while some are sedating and increase sleep. The difference in metabolism should make a difference in weight gain or loss. Another aspects is craving, if Wellbutrin can reduce the need for something as addictive as cigarettes, ..imagine what it might do for food addiction. Some of the newer diet drugs have very similar action to some ADs. Some anti-depressants (such as Efexor/Venlafaxine) do have side effects of causing weight gain and they do this in two ways. 1)They greatly lower your metabolism so even if you're taking a moderate amount of exercise and eating diet rations, you still gain weight or at the very least don't lose any. 2)They make you INCREDIBLY hungry so it is really difficult to resist eating too much. I personally resist the hunger pangs and take exercise, and although my weight has stopped rising, I simply can't lose anything. When you're depressed you have low self-esteem, and what you just don't need is fatness as well. The other point is, depression itself manifests in clusters of symptoms that apply to different people. Some people can't eat (I wish), can't sleep. Other people sleep all the time then binge when they wake up. I belong to the latter group. I have got it under control now, but when I was really ill I binged myself up to 14.5 stone. (I'm now 13 stone but can't seem to get any lower). There are various issues here. They seperate into thre factors: 1) Changed metabolism 2) Carbohydrate cravings 3) Direct increase in amount of fat storage (possibly metabolism independent?). I am no expert in this, so take what I say with a big pinch of salt. I am uncertain how much is really known about this. SSRIs tend to cause weight changes by 1. Drugs such as amitriptyline and other highly anticholinergic drugs, as well as Trazodone etc. cause weight gain by 2) as well as 1). This effect can be counteracted by self control. Drugs such as lithium seem to effect weight gain by 3) as well as 1). In this case maintaining the same weight is very hard. I suspect someone else can be more scientific than this. I really am showing my ignorance here!

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