Antidepressants and Weight Gain
The road to happiness needn't be paved with pounds
by Janet Kinosian
Any woman who takes antidepressant medication for more than eight weeks knows one thing well: Feeling healthy again usually means extra unwanted pounds that seem particularly resistant to shedding. The medical reasons for this are still being debated. What isn't up for debate is that most women want to drop that weight.
"It's multi-factorial, but the main guilty party appears to be the capacity of some antidepressants to block the histamine receptor, and once histamine is not working, we get appetite centers to go on, and we get hungry and eat," says Dr. Samuel Mowerman, a psychopharmacologist who is considered an expert in psychotropic medications and their side effects.
Medical literature generally agrees that Paxil, Zoloft, Remeron and Luvox appear to cause the most weight gain, with Prozac and Welbutrin sometimes causing weight decrease. However, many people still gain weight with any of the classes of antidepressant drugs. Rule of thumb: The higher the dosage of medication, the more likely weight gain will be an issue. Of course, this is not the case for every woman, and you should consult your own doctor about the side effects of any medication.
Here, a bevy of experts -- from MDs and PhDs to nutrition experts, exercise physiologists, trainers and stress managers -- offers up solutions to the dilemma.
Dr. Magdalena R. Naylor, MD, PhD, director, MindBody Medicine Clinic, University of Vermont
College of Medicine:
"If you're on a specific antidepressant and you're in remission, try to decrease the dose. Often, higher doses are responsible for more weight gain. If after a decrease of dose the weight continues as a problem, or depressive symptoms return, try to change the medication. There are some antidepressants within the same class that cause less weight gain, such as Prozac, which can often be substituted for Paxil or Zoloft. The newer antidepressant Cymbalta is advertised as not causing weight gain. We'll see in practice."
Jeff Rutstein, mindful exercise coach and author of Strengthening the Body to Heal the Mind. He
works with clients from Harvard's Mental Health facilities:
"Go easy at first. Don't set impossible goals or expect too much too fast. Work out three times a week on non-consecutive days. The key is proper form and focus, not the amount of weight lifted. I'd suggest starting with one exercise per body part and learning the proper form with a very light intensity -- crunches, chair squats, wall push-ups, triceps push-downs, etc.
"Check your intensity. While doing aerobic exercise, you should be able to have a conversation, but you shouldn't be able to sing. If you're unable to hold a conversation, you're exercising too hard; if you can sing, it's too easy."
Debbie Mandel, MA, stress management expert and author of Turn On Your Inner Light: Fitness
for Body, Mind and Soul:
"Omega threes seem to help a great deal. Eat fatty fish, walnuts, etc., or take supplements and gradually adjust to them. They can be a natural antidepressant and help stabilize blood sugar.
"Strength-train two times per week. Muscles burn more calories than fat, and strength training speeds up metabolism for up to 36 hours. Incorporate 45 minutes of cardio three to four times a week. Constantly change your fitness regime to wake up your body and avoid the dreaded plateau. The principle in strength training is to overload and adapt. You must make sure that you're exercising to your true potential and intensity -- not short-shrifting."
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