Does vilazodone (an antidepressant) cause weight gain?

Vilazodone and Weight Gain

Vilazodone does not cause weight gain and appears to have a favorable weight profile compared to many other antidepressants. 1

Weight Effects of Antidepressants

Different antidepressants have varying effects on body weight:

• Within the SSRI class, there is a range of weight gain potential, with paroxetine associated with the greatest risk for weight gain among SSRIs 2
• Fluoxetine and sertraline have been associated with weight loss during short-term use and weight neutrality with long-term use 2
• Tricyclic antidepressants (particularly amitriptyline), lithium, mirtazapine, and monoamine oxidase inhibitors are closely associated with weight gain 2, 3
• Bupropion is the only antidepressant consistently shown to promote weight loss 2, 3

Evidence Specific to Vilazodone

Vilazodone has demonstrated favorable weight characteristics:

• In a 12-week randomized controlled trial comparing vilazodone to sertraline, vilazodone showed similar efficacy but caused significantly less weight gain than sertraline 1
• Clinical trials data indicates that vilazodone was not associated with clinically relevant weight change in short-term trials 4
• In a one-year open-label study, mean weight increased by only 1.7 kg among observed cases, suggesting minimal long-term weight effects 4
• Vilazodone appears to have a favorable weight-gain profile based on available evidence 4, 5

Clinical Implications

When considering antidepressant selection with weight concerns in mind:

• Vilazodone may be preferred over other antidepressants when weight gain is a concern for patients 6, 1
• The medication should be administered with food to ensure adequate bioavailability 4
• Dose titration up to 2 weeks is required to reach the target dose of 40 mg/day due to potential gastrointestinal side effects 5
• The most common adverse events with vilazodone are diarrhea, nausea, vomiting, and insomnia 4

Limitations and Considerations

• While short-term data suggests minimal weight effects, longer-term controlled studies would help further characterize vilazodone's weight profile 4
• No direct comparative studies with many other antidepressants are currently available 5
• Weight gain in patients with psychiatric diagnoses is often multifactorial and not solely related to medication effects 2

When weight gain is a significant concern for patients requiring antidepressant therapy, vilazodone represents a good option with minimal impact on body weight compared to many other antidepressants.