From the FDA Drug Label
Patients treated with Escitalopram in controlled trials did not differ from placebo-treated patients with regard to clinically important change in body weight
- Weight Changes: The FDA drug label states that patients treated with escitalopram in controlled trials did not differ from placebo-treated patients with regard to clinically important change in body weight.
- However, under Other Reactions Observed During the Premarketing Evaluation of Escitalopram, it is mentioned that Metabolic and Nutritional Disorders include increased weight.
- Additionally, in the context of pediatric use, it is noted that Decreased appetite and weight loss have been observed in association with the use of SSRIs. Based on the information provided, it appears that escitalopram may not be associated with significant weight gain in adults, but there are some reports of increased weight and decreased appetite and weight loss in certain populations 1.
From the Research
Lexapro (escitalopram) is associated with a moderate risk of weight gain, with an estimated 6-month weight gain of 0.41 kg compared to sertraline, according to the most recent and highest quality study 2. This side effect is relatively common, affecting a significant proportion of patients. The weight gain is usually gradual and often occurs in the first six months of treatment. It's believed to be caused by changes in appetite, metabolism, and fluid retention associated with the medication's effects on serotonin levels. Some key points to consider:
- The risk of weight gain with escitalopram is higher compared to some other antidepressants, such as bupropion, which has been shown to have a weight-loss effect 3, 4.
- Unhealthy lifestyle factors, such as a Western diet, sedentarism, and smoking, can potentiate weight gain in individuals taking SSRIs, including escitalopram 5.
- The weight gain associated with escitalopram is generally modest, with an average increase of 0.14 kg over 12 weeks of treatment, as reported in an earlier study 6. To manage this potential side effect, it's essential to:
- Maintain a balanced diet
- Engage in regular exercise
- Monitor weight while on Lexapro If weight gain becomes significant or concerning, discuss it with your doctor, as they may adjust your dose, switch medications, or recommend additional strategies to manage your weight. Despite this potential side effect, the benefits of Lexapro for treating depression or anxiety often outweigh the risk of modest weight gain.