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Weight Gain on Psychotropic Drugs: Has the Obesity Community been Paying Attention

Judith J Wurtman

Weight gain is a well-known side effect of treatment with psychotropic drugs. More than fifty years ago, drugs such as amitriptyline (Elavil) and lithium were known to be associated with substantial increases in weight and despite new generations of psychotropic drugs, this unwelcome side effect has persisted [1-3]. How much weight is gained varies but in general mood stabilizers and antipsychotics drugs cause more substantial weight gain than antidepressants. Two antipsychotics, clozapine (Clozaril) and olanzapine (Zyprexa) are associated with the greatest prevalence of weight gain; up to 31% of patients treated with clozapine and 40% with olanzapine increase their weight during treatment [3]. Some mood stabilizers such as valproate (Depakote) [3] also are associated with a similarly high incidence of weight gain. Mirtazapine (Remeron) and paroxetine (Paxil) are two antidepressants with the greatest weight gain potential among the anti-depressants although except for buproprion (Wellbutrin) weight gain has been reported among all of the other drugs in this category