Why do you gain weight with antidepressants and mood stabilizers?

Why do you gain weight with antidepressants and mood stabilizers?

In this video I discuss two way. One way is by blocking histamine 1 receptors. We usually think of histamine as something that is associated with allergies and your immune response. If you’re exposed to something your body is sensitive to, you get a histamine response that can look like itching, runny nose or even shortness of breath. And if you take an antihistamine like Benadryl, it slows the allergic reaction and you feel better. That's how it works from the neck down. Histamine acts differently in your brain. In certain parts of your brain, it’s responsible for wakefulness or your ability to be alert. That's why if you take an anti-histamine it may reduce your allergic reaction, but if it crosses the blood brain barrier, it can also make you sleepy because it's blocking histamine’s stimulating effect in your brain. There are four histamine receptors, I’m going to talk about H1 receptors.
A second mechanism is blocking the 5HT 2c receptors. This is just a type of serotonin receptor. It’s been shown in mice that if you activate their 5HT2c receptors, they lose weight because they eat less. And if you block the receptor they became obese. Many of the newer antipsychotic medications block this receptor. Of all the antipsychotic medications, the worst offenders when it comes to weight gain are olanzapine, clozapine and quetiapine. And all three of these medications block 5HT2c.

In this video I also discuss what you can do to offset the weight gain.

References
He M, Deng C, Huang XF. The role of hypothalamic H1 receptor antagonism in antipsychotic-induced weight gain. CNS Drugs. 2013;27(6):423–434.

Nikhil Nihalani, Thomas L. Schwartz, Umar A. Siddiqui, and James L. Megna, “Weight Gain, Obesity, and Psychotropic Prescribing,” Journal of Obesity, vol. 2011, Article ID 893629, 9 pages, 2011

Halford JC1, Harrold JA. 5-HT(2C) Receptor agonists and the control of appetite. Handbook Exp Pharmacol. 2012;(209):349-56.

Dayabandara M, Hanwella R, Ratnatunga S, Seneviratne S, Suraweera C, de Silva VA. Antipsychotic-associated weight gain: management strategies and impact on treatment adherence. Neuropsychiatr Dis Treat. 2017;13:2231–2241.

Disclaimer: All of the information on this channel is for educational purposes and not intended to be specific/personal medical advice from me to you. Watching the videos or getting answers to comments/question, does not establish a doctor-patient relationship. If you have your own doctor, perhaps these videos can help prepare you for your discussion with your doctor.

[amy]

The worst part is that doctors don't bother telling you about this side effect and then act like you're crazy when you bring it up. Rapid weight gain makes me depressed and ruins my self-esteem, is that not important to consider when treating my mental health?!?!

[sheilamiller]

I put on and thankfully take off weight really easy. Gained 40 lbs on Celexa in 6 months. The weight alone will drive you further into depression.

[Munichmarty]

My doctor didn’t tell me about it. Just watched me getting fat and even more depressed. One of the reasons I mistrust doctors.

[Celta]

I was skinny and underweight. Then they put me on mood stabilizers (plural). Now, I'm about 200lbs and probably going to be pre-diabetic soon. Isn't life just wonderful! 😏

[ritahall]

Why aren’t doctors honest and up front with patients about weight gain - if you’re already depressed you only get worse ? Thank you for information

[tarcisiasiniscalchi]

What is really messed up is that every single doc who prescribed these meds just says, "oh, just eat healthy, walk, you won't gain weight", that is such a load of crap. It’s dishonest, inexcusable, and inadmissible. And stupid people who vomit thought-terminating clichés and say to just think positive, are equally stupid. Depression doesn’t go away with exercise or positive thinking or a healthy diet. Don’t confuse normal sadness with depression.

So, a depressed person needs these meds, but then they put so much weight on that they start becoming depressed over their weight. And doctors are dismissive and ignorant.

[cheerluv]

I was “skinny” my whole life and I’m not even joking, the only thing that changed with me was taking these meds at 19 for depression, bipolar, ptsd ect. and I gained 30lbs in less than 6 months… it was actually crazy and I got soooo insecure. I roughly lost 15lbs and I’m still trying to work on losing it 🙂

[ringspecies]

This explains A LOT. I reduced my eating to one meal per day, almost completely cut off any sugary drinks, etc. but would still gain weight, even though I thought that I was putting less in that my body was releasing out. But it's indeed true my body temperature rarely goes above 36.1, usually hovers in mid or high 35. Now it all makes sense.

[debram]

I've never seen a video that addresses the weight gain aspect of MH meds like this. THANK YOU! It's long overdue and so helpful!

[truedetectiveseason]

Skinny all my life...until I entered the realm of SSRIs.

[firstofall]

Yea I gained an enormous amount of weight after being forced to take mood stabilizers, antidepressants and antipsychotics. After I stopped taking them, I was still gaining weight. A year or two after not taking any, my weight started to go back down. I wasnt eating the best. But not that different from how I eat now. I can eat anything and maintain a reasonable weight now. I'd rather be mentally Ill than be fat like that from medication.

[noabrand]

This video and the comments are so helpful!! I’ve been saved by antidepressants but I’ve gained 17kg (~35 lbs) which is so hard on my mental health and joints. I’ve never had so much trouble losing weight in my life, and was being super hard on myself. After watching this, I can relax a bit. Thank you!

[clairefutrell]

I got put on Lexapro six months ago. I was already overweight and aware that it could potentially cause weight-gain.
That being said, once my mental health began to improve, I was able to make healthy lifestyle changes. I’ve lost 43lbs in 5 months so far.

[bobbobson]

first admission i came across. pychiatrists i came across deny any side effects all together. thank you for your honesty

[Julieroo]

You’re certainly right about Paxil. It made me hungry. I went from eating like a bird to cleaning my plate and wanting dessert. It also made me want to eat when I wasn’t hungry. I’d wake up in the middle of the night and want to stuff my face with potato chips. Bottom line is I gained a lot of weight, totally lost my libido and felt like a zombie. Ugh.

[jigglypuffever]

Thank you for validating us. Internet and doctors and only says “you gain weight because you’re hungrier” and “you only gain a few pounds.” I weighed 110 lbs when starting Zoloft at age 26…. 10 years later im 160 lbs. And when I went off Zoloft in short term stretches I went back to my original weight. Every time I try to go down or go off of it, anxiety creeps back in. I’m thankful for the medicine but the side effects are a struggle.

[carkrueger]

I’ve been asking doctors this very question for over a decade. Finally, a straight answer. Thank you so much!

[stephaniesinternetlife]

Thank you so much for this! I was put on anti-depressants and gained 35 pounds. I told my doctor and she blamed it on my diet. I started to keep a food diary and the next doctors visit I still gained weight even though I was eating less. Now I’m on a different medication but it’s still hard to lose weight and it’s made me feel insecure 😕 But I’m so glad that I was right!!

[gabibraga]

I always made clear to my doctors that, besides borderline and depression, I've always struggled with ED. They wouldn't bothered to tell me the side effects of the antipsychotics and mood stabilizers till I showed up with overweight and completely destroyed, only then realizing that no, I wasn't eating that much to look like that.

[OzmaOfOzz]

So we re depressed, take anti depressants, gain weight and get even more depressed. Friggin great. At least anxiety keeps me thin
Later edit: it s hilarious to me how much controversy my comment caused. It was a joke, in case you didnt get it. Sorry if it offended you. Mental health is serious and you should get help, obv.