From the Guidelines
Medications that can cause weight gain include antipsychotics, antidepressants, glucocorticoids, injectable progestins, anticonvulsants, β-blockers, and sedating antihistamines and anticholinergics, as reported in the most recent study 1. When considering medications that may promote weight gain, it is essential to weigh the benefits against the potential risks, particularly in patients with a history of obesity or those who are at risk of developing weight-related complications. Some key medication classes associated with weight gain are:
- Antipsychotics (e.g., clozapine, olanzapine, risperidone)
- Antidepressants (e.g., tricyclic antidepressants, some selective serotonin reuptake inhibitors, and monoamine oxidase inhibitors)
- Glucocorticoids
- Injectable progestins
- Anticonvulsants (e.g., gabapentin, pregabalin)
- β-blockers (e.g., atenolol, metoprolol, propranolol)
- Sedating antihistamines and anticholinergics As noted in a recent review 1, many commonly used medications are associated with weight gain, and clinicians should select therapies least likely to cause weight gain among options with similar efficacy. Healthcare professionals should carefully review the individual’s concomitant medications and, whenever possible, minimize or provide alternatives for medications that promote weight gain 1. In terms of managing medication-induced weight gain, medications like metformin and topiramate can be considered as adjunctive therapy, as they have been shown to counteract the effects of some weight gain-promoting agents, particularly antipsychotics 1. Lifestyle modifications, including dietary changes and increased physical activity, should accompany medication treatment, and regular monitoring for side effects is essential.
From the FDA Drug Label
Metabolic Changes: Atypical antipsychotic drugs have been associated with metabolic changes that may increase cardiovascular/ cerebrovascular risk. These metabolic changes include hyperglycemia, dyslipidemia, and weight gain. Weight Gain: Weight gain has been reported. Monitor weight gain.
Medications that cause weight gain include atypical antipsychotics, such as ziprasidone.
- Key points:
- Weight gain has been reported with ziprasidone.
- Monitor weight gain in patients taking ziprasidone. 2
From the Research
Medications that Cause Weight Gain
- Antipsychotic medications, including atypical antipsychotics such as clozapine and olanzapine, have been associated with significant weight gain 3, 4, 5, 6
- Mood stabilizers, such as lithium and valproate, have also been linked to weight gain 3, 6
- Antidepressants, including tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs), can cause weight gain, although the effect may be less pronounced than with antipsychotics 3
- Other medications, such as ziprasidone and aripiprazole, may have a neutral or minimal effect on weight gain, but can still cause weight gain in some individuals 4, 5
Mechanisms of Weight Gain
- Increased appetite and food cravings, potentially due to medication interactions with brain monoaminergic and cholinergic systems 3, 6
- Metabolic and endocrine effects, such as hyperprolactinemia, which can contribute to weight gain 6
- Altered resting metabolic rate and changes in energy balance regulation 3
Management of Weight Gain
- Lifestyle interventions, including dietary advice and increased physical activity, can help prevent or manage weight gain 4, 7
- Pharmacological adjunctive treatments, such as metformin, may be effective in preventing or reversing weight gain, although more research is needed 4, 7
- Close monitoring of weight, body mass index (BMI), and metabolic parameters, such as blood glucose and lipids, is essential for patients taking medications that can cause weight gain 3, 6