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Weight gain and diabetes are serious side effects of antidepressants. Since depression is becoming a very common condition, doctors must monitor their patients who are taking these drugs to reduce their risk of suffering from these side effects.

Many people who are taking antidepressants may be relieved that they are able to overcome chronic sadness and anxiety and manage to improve their social life and work productivity. However, a lot of these people also notice that they have been gaining a significant amount of weight or are unable to lose weight in spite of diet and exercise.

Studies have also shown that the link between antidepressant therapy and the risk of developing diabetes is real.

Researchers at the University of Southampton warn that clinicians must be more careful in prescribing antidepressants since these can increase their patients’ risk of developing the disease. Close to 47 million UK adults were prescribed some antidepressants in 2011. A systematic review of 22 studies plus three previews reviews done in the University revealed that patients who used antidepressants at higher doses or for extended duration were at increased risk of developing diabetes type 2.

Experts recommend that doctors should be aware of this risk when prescribing these drugs, and that they should monitor their patients for diabetes and encourage them to reduce that risk through lifestyle modification.

The results of the latest systematic reviews support previous findings in population-based studies in other countries, such as those conducted in Canada, which involved 2,400 people, and in Finland, which involved more than 15,000 adults. Scientists found that increasing daily doses of antidepressants were associated with elevated absolute risk for type 2 diabetes.

They also found that the risk of gaining weight was doubled among users of antidepressants compared to non-users.

Studies show that these effects occurred in patients who used tricyclic antidepressants or SSRIs, and that the effect was increased when both were used.

Other studies also suggest that aside from antidepressants, antipsychotic drugs used to treat other mental illnesses such as schizophrenia, as well as atypical antipsychotics, which are often prescribed for mood disorders, can also increase the risk for weight gain and diabetes.

Recommendations

Should a patient taking antidepressants stop using them to avoid the risk of diabetes?

Experts do not recommend abruptly stopping their treatment for depression because major depressive symptoms are bound to come back. Instead, one can ask their doctors to prescribe other types of antidepressants with lesser risk of weight gain, or to combine their current medications with another type of medication that can boost its positive effects and reduce its side effects. Some doctors may combine serotonin-based antidepressants with bupropion (Wellbutrin), another type of antidepressant that does not cause weight gain, or with other "antidotes" such as orlistat (Xenical), an anti-obesity drug, and metformin (Glucophage), an anti-diabetic drug.

For some patients, however, weight gain is not necessarily a negative effect. Many depressed patients who have lost a lot of weight, such as cancer patients, may benefit from an increase in appetite. This weight gain does not necessarily lead to diabetes, but in fact, may improve their sense of well-being.

Physicians can also suggest the use other modes of treatment such as cognitive behavioral therapy or group therapy to manage their depression and reduce the need for medications. Alternative treatments such as acupuncture, yoga, and other meditation and relaxation techniques have also been found to be helpful.

Finally, patients taking antidepressants may reduce their intake of these drugs by combining their treatment with lifestyle modifications that can reduce weight gain, such as diet and exercise. Eating a healthy diet and increasing physical activity not only help control weight and blood sugar levels, but they can also boost one's mood and self-confidence, thus reducing anxiety levels.