Weight gain in depression remitted with antidepressants: pharmacological or recovery effect?

Depression remission is often associated with weight gain. It is not clear if weight gain is caused by a pharmacological effect of antidepressants, or if instead it is an effect of recovery from depression. The aim of this study was to try to clarify this point.

One hundred consecutive unipolar/bipolar remitted depressed private practice outpatients (DSM-IV diagnoses with structured interview) were interviewed with structured questions about weight changes occurring during depression and remission. Comparisons were made between remitted weight gainers and remitted nonweight gainers.

Seventy-two percent of patients showed weight gain when they remitted from depression, in comparison with their weight when they were depressed. No significant differences were found in age, gender, diagnoses, duration of remission, use of tricyclics, tricyclic-SSRI combination, benzodiazepines, neuroleptics, and mood stabilizers in remitted weight gainers versus nonweight gainers. SSRIs were significantly more used in remitted nonweight gainers. Significantly more weight loss and less weight gain when depressed were found in remitted weight gainers versus nonweight gainers.

These findings suggest that weight gain in remitted depressed patients may not necessarily be a pharmacological effect of antidepressants, but may rather be an effect, at least in part, of recovery from depression.