Possible causes of weight gain.

There can be more than one cause of weight gain during the treatment of depression, so a multi-pronged approach to the patient's medication regimen is necessary. Appetite can be affected by physical (chemical, metabolic) and psychological (cultural, familial) factors. In addition, the disease is affected, as depression itself can lead to an increase in diet; Also anxiety, which sometimes causes strong and uncontrollable eating.

Weight gain approach

Lifestyle changes. Small portion sized meals should be the first step, along with restricting high-calorie, high-fat foods. A simple suggestion is to ask the patient to eat the same foods, but remove the 20% portion, as well as recommendations on sleep hygiene and insomnia management. Under the supervision of a nutritionist or nutritionist, more severe calorie restrictions can be imposed. Some patients may ask about extreme measures, such as low calorie diets and strenuous exercise programs that have become popular in the media. Although weight loss should be encouraged to start and maintain, the goal should be to do it slowly.

Psychotherapy can be an important intervention in initiating and maintaining weight loss. Cognitive Behavior Therapy (CBT) can help patients identify and modify habits and reinforce behaviors that promote weight loss. Encouraging interviews are a useful tool in addition to psychotherapy and have shown promise in treating obesity and overeating.

Medications to consider

When drug use is considered as a point of intervention, the possibility of switching from antidepressants to one that is not associated with significant weight gain should be considered.

How do atypical antidepressants work?

Atypical antidepressants relieve depression by affecting the chemical messengers (neurotransmitters) used to communicate between brain cells. Like most antidepressants, atypical antidepressants ultimately work by affecting changes in brain chemistry and communication circuits in brain nerve cells known to regulate mood, to help alleviate depression.

Abnormal antidepressants alter the levels of one or more neurotransmitters, such as dopamine, serotonin, or norepinephrine.

Extraordinary antidepressants approved by the Food and Drug Administration

The Food and Drug Administration (FDA) has approved these atypical antidepressants for the treatment of depression:

  • Bupropion (Wellbutrin SR, Wellbutrin XL, others)
  • Mirtazapine (Remron)
  • Nefazodone
  • trazodone
  • Vilazodone (Viibryd)
  • Vortioxetine (Brintellix)

A new antidepressant called esketamine (Spravato) has been approved by the FDA for treatment for resistant depression. This is a nasal spray that is used in conjunction with an oral antidepressant.

Possible side effects of Atypical Antidepressants

Antidepressants can have side effects, including atypical antidepressants, although some people may not experience it. Some side effects may subside after a while, while others may prompt you and your doctor to try a different medication.

Because of the different ways atypical antidepressants work, each has its own unique characteristics and variable potential side effects. For example:

  • Most atypical antidepressants list dry mouth, dizziness, or mild headache as possible side effects.
  • Some antidepressants can help you sleep and are best used at night, while others can cause insomnia.
  • Some antidepressants can cause constipation, while others can increase the risk of diarrhea.
  • Some antidepressants can increase your appetite, which can lead to weight gain, while others can cause nausea.
  • Some antidepressants are more likely to cause sexual side effects than others.

Deciding which antidepressant is best for you depends on many factors, including your symptoms and any other condition of your health. Ask your doctor and pharmacist about the most common side effects of your specific antidepressant, and read the patient's medicine guide that comes with your prescription.

Suicide risk and antidepressants

Most antidepressants are generally safe, but the FDA requires all antidepressants to have black box warnings, which are the strongest prescription warnings. In some cases, children under the age of 25, adolescents and young adults taking antidepressants may have increased suicidal thoughts or behaviors, especially in the first few weeks after onset or when the diet is changed. Is.

Anyone taking antidepressants should be closely monitored for depression or abnormalities. If you or someone you know has suicidal thoughts while taking antidepressants, contact your doctor immediately or seek emergency help.

Keep in mind that antidepressants are more likely to reduce the risk of long-term suicide because the mood improves.

Suspension of treatment with atypical antidepressants.

Atypical antidepressants are not considered addictive. However, abruptly stopping antidepressant treatment or missing more than one dose can cause symptoms such as withdrawal. Symptoms may vary depending on how the medicine works. This is sometimes called discontinuation syndrome. Work with your doctor to gradually reduce your dose.

Finding the right antidepressant

People may react differently to the same antidepressant. For example, a particular medicine may work (or not) better for you than any other. Or you may have more or less side effects from taking a specific antidepressant than any other.

Hereditary traits can affect how antidepressants affect you. In some cases, the results of special blood tests (if they are performed) may indicate how your body may respond to a particular antidepressant. However, variables other than genetics can affect your reaction to the drug.