I take Wellbutrin and Zoloft. Do these cause weight gain?

  • Q: I take Wellbutrin and Zoloft. Do these cause weight gain?
  • A: Drugs can cause weight gain in several different ways. Some can increase appetite or make you crave certain types of foods like those high in carbohydrates or fat. Other medications may slow down metabolism or cause fluid retention. However, the effect of prescription drugs on body weight is complex. Some drugs have no effect on weight, while others cause weight gain or weight loss. Also, the same medications can cause weight gain in certain individuals and weight loss in others. There are also drugs that initially cause weight loss and then lead to weight gain with long-term use. Most prescription medications associated with changes in body weight affect the central nervous system. These include antidepressants like monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, and selective serotonin reuptake inhibitors (SSRIs). Mood stabilizers (lithium, valproic acid), antipsychotics, and anticonvulsants have also been linked with weight gain. Zoloft (sertraline) is an antidepressant in the SSRI class of drugs. SSRIs affects chemicals in the brain that may become unbalanced and cause a variety of disorders. Zoloft is used to treat depression, obsessive-compulsive disorder, panic disorder, anxiety disorders, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD). Wellbutrin (bupropion) is also an antidepressant medication, although it works slightly differently than the SSRIs. It is used to treat major depressive disorder and seasonal affective disorder. The SSRIs and a related class, the selective norepinephrine reuptake inhibitors (SNRIs) are some of the most widely used depression medications on the market. These two classes of drugs have become so widely prescribed because their side effects are limited compared to some of the older antidepressants. However, they still do have some side effects. And weight gain can be a common side effect of both of these classes of drugs. Keep in mind that patients may react differently to different medications within these classes. If side effects, like weight gain, become bothersome, it sometimes helps to switch medications. Consult your healthcare provider for specific recommendations. Available SSRIs include paroxetine (Paxil), fluoxetine (Prozac), fluvoxamine (Luvox), sertraline (Zoloft), escitalopram (Lexapro), and citalopram (Celexa). The SNRIs include venlafaxine (Effexor) and duloxetine (Cymbalta). Other drugs that have been reported to cause weight gain include diabetes medications (insulin, sulfonylureas, and thiazolidinediones), antihypertensive drugs, certain hormonal contraceptives, corticosteroids, antihistamines, some chemotherapy regimens, and antiretroviral protease inhibitors. If you think a drug you are taking is causing weight gain, tell your health care provider. Do not stop any medication or change the dose without first talking to your provider. Your healthcare provider is best able to guide your choice of treatment based on your specific circumstances. For more specific information, consult with your doctor or local pharmacist for guidance based on your health status and current medications. Sarah Lewis, RPh, PharmD
This question was answered on October 13, 2010.


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