From the Guidelines
Paroxetine is the SSRI most commonly associated with weight gain, with patients potentially gaining 1-5 kg over months of treatment, as noted in the study published in Gastroenterology 1. The mechanism behind SSRI-related weight gain involves several factors, including serotonin's role in appetite regulation, potential metabolic changes, reduced physical activity due to sedation, and improved appetite following depression recovery. Some key points to consider when evaluating the potential for weight gain with SSRIs include:
- Paroxetine and citalopram are more likely to cause weight gain compared to other SSRIs, such as fluoxetine and sertraline, which are generally considered more weight-neutral, especially during short-term use 1.
- The weight gain associated with SSRIs typically occurs gradually over months rather than immediately.
- If weight gain is a concern, discussing with your healthcare provider about potentially switching to a more weight-neutral option like fluoxetine or sertraline, or adding lifestyle modifications such as regular exercise and dietary adjustments may help mitigate this side effect while maintaining effective treatment of depression or anxiety. It's essential to weigh the potential benefits of SSRIs against the potential risks, including weight gain, and to work closely with a healthcare provider to determine the best course of treatment for individual patients.
From the Research
SSRI that Cause Weight Gain
- Paroxetine is an SSRI that has been associated with weight gain, as noted in studies 2, 3
- The potential for discontinuation syndrome and weight gain appears to be slightly higher with paroxetine than with other SSRIs 3
- A comparison of fluvoxamine, fluoxetine, sertraline, and paroxetine found that paroxetine was associated with a higher incidence of withdrawal symptoms, including weight gain 4
- A systematic review of SSRIs found that paroxetine was associated with a higher incidence of sedation, tremor, sweating, sexual dysfunction, and discontinuation reactions, including weight gain 5
- The exact mechanisms by which paroxetine causes weight gain are not fully understood, but it is thought to be related to its effects on serotonin levels and appetite regulation 2, 3