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Prescription Drugs and Weight Gain

This section is about the existence of drugs that can cause weight gain by increasing hunger. It is not a call for us to abandon prescription drugs. In the United States, the average person born at the beginning of the twentieth century could expect to live to about age 47. By 2008, despite increased obesity, life expectancy at birth had risen to about age 78.¹

Most deaths at the beginning of the twentieth century were from infectious disease. Today in the United States, infectious disease is not even in the top three causes of death. The top two causes are now heart disease and stroke, for which being overweight is a major risk factor.²

Fortunately, while weight gain can be a side effect of many prescription drugs for some people, different drugs cause weight gain in different people. If a prescription drug can be identified as a cause of weight gain, it may be possible for you and your doctor to try alternative drugs. For those of us who are not taking any of these drugs, the following list is still interesting, because it shows us how common it is for drugs to cause weight gain by affecting appetite. It is not always understood why they have this effect, but none of these drugs has been shown to cause weight gain by altering metabolism. This list is just a sample.

Drugs with Weight Gain as a Side Effect

Class:	Anticonvulsants
Names:	Lamictal®, Tegretol®
Effects:	Anticonvulsants are used mainly to treat seizure disorders but are also prescribed to treat bipolar disorder and certain types of depression.
Appetite:	These drugs tend to cause elevated insulin levels in the blood (hyperinsulinemia) and increased appetite, leading to weight gain.³

Class:	Antidepressants
Names:	Paxil®, Zoloft®, Prozac®
Effects:	Antidepressants are used to treat major depression. The exact mechanism of the therapeutic effects is controversial.
Appetite:	While the specific mechanism is unknown, it is known that antidepressants are associated with increased food cravings and an inability to feel full despite eating more than enough.⁴

Class:	Antipsychotics
Names:	Zyprexa®, Seroquel®, Risperdal®
Effects:	Antipsychotics are used to treat schizophrenia, mania, delusional disorder, and psychotic depression. They work by blocking receptors in the brain’s dopamine pathways.
Appetite:	Animal studies have suggested that antipsychotics affect appetite regulation.⁵

Class:	Beta-Blockers
Names:	Tenormin®, Lopressor®
Effects:	Beta-blockers are used in the treatment of high blood pressure, panic attacks, and abnormal heart rhythms. They block adrenaline, causing heart rate to slow.
Appetite:	The older Beta-Blockers caused high blood insulin level, which is associated with increased hunger. The newer Beta-Blockers are not associated with weight gain.⁶

Class:	Mood Stabilizers
Names:	Lithium, Depakote®, Seroquel®
Effects:	Mood stabilizers are used to treat mental disorders in which there are intense and persistent mood shifts, including bipolar disorder. They are also used to treat borderline (psychotic) personality disorder.
Appetite:	This class of drugs can cause increased appetite and cravings for sweet and fatty foods.⁷

Class:	Steroids
Names:	Prednisone®, Triamcinolone, Betamethasone
Effects:	Steroids, which are different from anabolic-steroids used by weight builders to gain muscle, are used to treat inflammatory conditions such as dermatitis, arthritis, and asthma.
Appetite:	These drugs cause weight gain in nearly all patients who take them.⁸

Class:	Antihistamines
Names:	Allegra®, Benadryl®, Zyrtec®
Effects:	Antihistamines are used as treatment for allergies. They inhibit the release of histamine, which is present in excessive amounts in people with allergies.
Appetite:	Hunger may increase with these drugs because histamine receptors are involved in appetite regulation. While people do not complain that they feel hungry, it is observed that they are eating more.⁹ This occurs in a small percentage of patients.

Class:	Non-Steroidal Anti-Inflammatories (NSAIDS)
Names:	Celebrex®, Licofelone®
Effects:	Non-steroidal anti-inflammatories are used as treatment for pain and inflammation in conditions such as headache, migraine, arthritis, and gout. They inhibit the action of the enzyme cyclooxygenase.
Appetite:	Weight gain is a reported side effect of NSAIDS but the mechanism of action has not been studied.¹⁰

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Citations:

¹ "CIA – The World Factbook – Field Listing: Life Expectancy at Birth." Central Intelligence Agency. 4/04/2009 https://www.cia.gov/library/publications/the-world-factbook/fields/2102.html.

² Kristen Mauk. Gerontological Nursing: Competencies for Care. Jones & Bartlett Publishers, 2006, pp. 37–38.

³Gay Riley. "The Relationship Between Weight Gain and Medications for Depression and Seizures." NetNutritionist.com. 4/04/2009 http://www.netnutritionist.com/fa12.htm.

⁴O. Ruetsch and others. "Psychotropic Drugs Induced Weight Gain: A Review of the Literature Concerning Epidemiological Data, Mechanisms and Management." The Good Drug Guide. 4/04/2009 http://biopsychiatry.com/weight-gain.htm.

⁵Daniel K. Hall-Flavin. "Antipsychotic Medications: Is Weight Gain Inevitable?" Mayo Clinic. 4/04/2009 http://www.mayoclinic.com/health/antipsychotic-medications/AN01685.

⁶Gabe Mirkin. "Beta Blockers Side Effects." www.DrMirkin.com. 4/04/2009 http://www.drmirkin.com/heart/7642.html.

⁷O. Ruetsch and others. "Psychotropic Drugs Induced Weight Gain: A Review of the Literature Concerning Epidemiological Data, Mechanisms and Management." The Good Drug Guide. 4/04/2009 http://biopsychiatry.com/weight-gain.htm.

⁸"Prednisone." Johns Hopkins Vasculitis Center. 4/04/2009 http://vasculitis.med.jhu.edu/treatments/prednisone.html#weight.

⁹Mary Duenwald. "Is Your Medicine Cabinet Making You Fat?" New York Times. 4/04/2009 http://www.nytimes.com/2005/08/16/health/16cons.html.

¹⁰"Medication Guide for Non-Steroidal Anti-Inflammatory Drugs." U.S. Food and Drug Administration. 4/04/2009 http://www.fda.gov/CDER/drug/infopage/COX2/NSAIDmedguide.htm.

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