We are publishing a preview of part of an article in the new Corriere Salute. You can read the full text on the issue at newsstands for free on Thursday 8 July or in Pdf on the Digital Edition of Corriere della Sera.
If not unlikely someone will decide not to start antidepressant treatment in fear of gaining weight, it is even more likely that he will interrupt her as he sees the balance needle shift. Is it really true that antidepressants make you gain weight? Or are there other factors that come into play? And then, in this respect, are all drugs the same? Absolutely not – replies Giancarlo Cerveri, director of the Psychiatry Unit of ASST in Lodi – but let’s start by emphasizing that almost all antidepressants are also active against anxiety which, among the many negative effects, has some little known intestinal peristalsis and basal metabolism because it increases muscle tension. In short, the internal “engine” is always accelerated and in fact there is a feeling of perennial fatigue and often, in the evening, the muscles are painful. Not infrequently, all this leads to weight loss, but when the drugs begin to act, and the anxiety to subside, its side effects are also reduced and not infrequent that, if the introduction of food is not modified and not physical activity increases, weight increases, but this is not a direct effect of medicines, but a symptom of improvement in the pathology.
Beyond these effects, are there antidepressants that actually directly make you fat? All those with strong antihistamine activity, in particular mirtazapine. I would like to make a distinction. While everyone knows that antihistamines used to fight allergies often cause weight gain, the ones we psychiatrists use are different. The former are hydrophilic, that is, they dissolve in water, and this allows them to easily reach the mucous membranes of the nose where they have to act; the latter are lipophilic, dissolve in fat and then end up in the brain, which is the “fattest” organ in our body ”causing a sedative effect by binding to the histaminergic receptors present there. Another antidepressant often associated with weight gain is paroxetine, one of the many SSRIs, drugs that inhibit the “reuptake” of serotonin, the “good mood” neurotransmitter.
What are the absolute antidepressants with the least effect on weight? Fluoxetine, another SSRI, which has no effect on appetite-increasing receptors.
You can continue reading the article on the Health Courier on newsstands for free on Thursday 8 July or in Pdf on the Digital Edition of Corriere della Sera.
July 7, 2021 (change July 7, 2021 | 19:13)
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