Lexapro (escitalopram) is a commonly prescribed antidepressant used to treat depression and anxiety disorders. Understanding its potential impact on weight is essential for individuals considering or currently taking this medication. While Lexapro can be beneficial in managing mood disorders, it can also lead to changes in appetite and weight, which can be a concern for some individuals. This article explores the relationship between Lexapro and weight changes, offering insights and strategies for managing these effects.
What is Lexapro?
Lexapro, known generically as escitalopram, belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). These medications work by increasing the levels of serotonin in the brain. Serotonin is a key messenger chemical that helps regulate mood. Doctors may prescribe it to treat mood disorders, such as depression and anxiety.
How Lexapro Works
SSRIs work by increasing the amount of serotonin in the brain. Serotonin is a hormone and neurotransmitter that helps regulate mood. By increasing serotonin levels, Lexapro can help alleviate symptoms of depression and anxiety.
Lexapro and Weight Changes: What the Research Says
Lexapro can cause changes in weight, but individual experiences can vary significantly. While some people may experience weight gain, others may lose weight or see no change at all.
Weight Gain
Some people experience weight gain while taking Lexapro, although this can vary depending on the individual and various factors. One study shows that, after 6 months of treatment, 13.3% of participants gained more than 2kg, while 7.6% lost 2kg or more. Weight gain occurs in about 41% of people taking Lexapro, with typical gains of 2.4-4 pounds over 8-9 months, making it less likely to cause weight gain than many other antidepressants.
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A 2018 review compared weight changes with various antidepressants and concluded that the average weight gain with Lexapro was 3.7%.
Weight Loss
There are some reports that people begin to lose weight when first taking Lexapro, but this finding is not well supported by research studies. Lexapro, as with other SSRIs, may cause some weight loss, particularly at the start of treatment, within the first 4 to 12 weeks. Again, this can vary significantly from person to person, and some people may not experience weight loss at all during Lexapro treatment.
Appetite Changes
Lexapro’s prescribing information states that people using the drug to treat major depression may experience significant changes in weight and appetite. These include both increases and decreases.
Why Do Antidepressants Affect Weight?
Experts do not know precisely why weight changes occur with antidepressant use. One reason may be that they boost serotonin, which plays a role in managing appetite. The medication may increase appetite directly, or a person may begin to eat more as their depression or anxiety lessens. Depression and anxiety can also affect eating habits - people may eat more or less than usual. Lifestyle measures, such as changes in diet and exercise, may also affect a person’s appetite and weight. More research is necessary to understand the connection between SSRIs and weight gain.
Factors Influencing Weight Changes on Lexapro
How the medication affects individuals will vary from person to person and may depend on several factors, including:
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- Duration of treatment: Weight might continue to increase as treatment continues, meaning that longer treatments can lead to more weight gain overall.
- Being underweight before the commencement of treatment: People who are underweight before starting treatment may be more likely to experience weight gain with Lexapro. It is common for depression to cause reduced appetite, thus leading to weight loss during depressive episodes. As such, when treatment commences, this symptom is reduced and appetite returns to normal.
- Being overweight before treatment: Some people experience increased appetite during depressive episodes, thus contributing to weight gain before treatment.
- Lifestyle: A sedentary lifestyle, with limited physical activity or exercise, can increase your chances of weight gain while taking Lexapro.
- Age: Age can also be a factor, as metabolism naturally slows down as we get older.
- Pre-existing conditions: Pre-existing health conditions can also influence your risk. People with diabetes, thyroid disorders, or other metabolic conditions might be more likely to experience weight changes. Additionally, if you're taking other medications alongside Lexapro, there could be interactions that affect your weight.
Timeline of Weight Changes
Understanding when weight changes might occur can help you monitor your body's response to Lexapro and discuss any concerns with your healthcare provider. Weight changes don't typically happen immediately; they usually develop gradually over time.
- First 2-4 weeks: Possible initial weight loss due to decreased appetite
- 1-3 months: Weight often stabilizes as your body adjusts
- 6+ months: Most weight gain occurs during this period
- Long-term: Weight may continue to increase gradually if not managed
It's important to remember that not everyone follows this exact timeline. Some people might experience changes earlier or later, and others might not experience significant weight changes at all.
Comparison with Other Antidepressants
When considering Lexapro, it's helpful to understand how its weight gain potential compares to other antidepressant medications. The weight gain experienced with Lexapro is a lot less than that reported with other antidepressants such as paroxetine, mirtazapine, or doxepin. Lexapro and most other selective serotonin reuptake inhibitors (SSRIs) are more likely to cause weight gain if you take them long term. However, when compared to other antidepressants, Lexapro falls into the moderate risk category, making it a reasonable choice for many people concerned about weight changes.
Strategies for Managing Weight While Taking Lexapro
If you're concerned about weight gain while taking Lexapro, there are several strategies you can use to help manage your weight. The prescribing doctor can suggest how to manage appetite and weight when commencing or during treatment.
- Engage in regular physical activity: Aim for at least 150 minutes of moderate exercise per week.
- Eat a healthy and balanced diet: Follow a varied diet with plenty of fresh ingredients.
- Ensure proper hydration: Stay hydrated and limit sugary drinks.
- Maintain a sleep routine: Get adequate sleep, as poor sleep can affect weight regulation. Aim for 7-9 hours of quality sleep each night.
- Manage stress:
- Consider working with a registered dietitian:A registered dietitian for personalized nutrition advice.
- Track your weight regularly: Monitor your eating patterns and practice mindful eating.
- Avoiding high fat, high sugar foods: Eating regular meals and healthy snacks.
- Engaging in behavioral therapies: Behavioral therapies can also be useful, as they can help people with mental health conditions such as depression and anxiety, as well as teach coping strategies to manage food cravings and eating behaviors.
These strategies can help manage mental and physical well-being, improve mood, and reduce potential weight gain.
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When to Talk to Your Doctor
Open communication with your healthcare provider is essential when you're taking Lexapro, especially if you're concerned about weight changes. If you start to have problems with your weight while taking escitalopram, talk to your doctor or pharmacist. Don't wait until you've gained a significant amount of weight - it's better to address concerns early when they're easier to manage.
Your doctor might suggest adjusting your dose, switching to a different medication, or implementing specific lifestyle changes. They can also help you determine whether the benefits of continuing Lexapro outweigh the concerns about weight gain. Remember, never stop taking Lexapro suddenly without talking to your doctor first. Abruptly stopping antidepressants can cause withdrawal symptoms and may cause your depression or anxiety to return.
Important Considerations and Warnings
It is very important that your doctor check your progress at regular visits to allow for changes in your dose and to help reduce any side effects. Blood tests may be needed to check for any unwanted effects. Do not take escitalopram with a monoamine oxidase (MAO) inhibitor (eg, isocarboxazid [Marplan®], linezolid (Zyvox®), methylene blue injection, phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]). Do not start taking escitalopram during the 14 days after you stop a MAO inhibitor. Wait 14 days after stopping escitalopram before you start taking a MAO inhibitor.
If you take them together or do not wait the proper amount of time, you may develop confusion, agitation, restlessness, stomach or bowel symptoms, a sudden high body temperature, an extremely high blood pressure, or severe seizures. Do not take escitalopram with pimozide (Orap®). Using these medicines together can cause very serious heart problems.
Escitalopram may cause some teenagers and young adults to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Some people may have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. If you or your caregiver notice any of these unwanted effects, tell your doctor right away. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.
Check with your doctor right away if you or your child have anxiety, change or loss of consciousness, confusion as to time, place, or person, diarrhea, dizziness, dry mouth, extremely high fever or body temperature, holding false beliefs that cannot be changed by fact, hyperventilation, increased sweating, irregular heartbeats, irritability, muscle cramps, muscle twitching or jerking, nausea, pale, clammy skin, nervousness, redness of the face, neck, arms and occasionally, upper chest, restless, rhythmic movement of muscles, seeing, hearing, or feeling things that are not there, shakiness in the legs, arms, hands, or feet, trembling or shaking of the hands or feet, trouble breathing, trouble sleeping, or vomiting. These may be symptoms of a serious condition called serotonin syndrome. The risk may be higher if you or your child also take certain other medicines that affect the serotonin levels in the body. Do not use escitalopram with buspirone (Buspar®), fentanyl (Abstral®, Duragesic®), lithium (Eskalith®, Lithobid®), tryptophan, St. John's wort, amphetamines, or some pain or migraine medicines (eg, meperidine, methadone, rizatriptan, sumatriptan, tramadol, Demerol®, Frova®, Imitrex®, Maxalt®, Methadose®, Relpax®, Ultram®, Zomig®). Check with your doctor first before taking any other medicines with escitalopram.
Do not suddenly stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely. This will decrease the chance of having withdrawal symptoms such as increased anxiety, burning or tingling feelings, confusion, dizziness, headache, irritability, nausea, trouble sleeping, or unusual tiredness or weakness. This medicine may increase your risk for bleeding problems. Make sure your doctor knows if you are also taking other medicines that thin the blood, including aspirin, NSAIDs (eg, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Voltaren®), or warfarin (Coumadin®, Jantoven®).
This medicine may cause hyponatremia (low sodium in the blood). This is more common in elderly patients, those who are taking diuretic medicines for high blood pressure, or those who have decreased amounts of fluid in the body due to severe diarrhea or vomiting. Check with your doctor right away if you have confusion, headache, memory problems, trouble concentrating, weakness, or unsteadiness. This medicine may cause some people to become drowsy, have trouble with thinking or controlling body movements. Make sure you know how you react to escitalopram before you drive, use machines, or do anything else that could be dangerous if you are not alert or well-coordinated. The use of alcohol is not recommended in patients who are taking escitalopram.
Check with your doctor right away if you have decreased interest in sexual intercourse, delayed or inability to have an orgasm, inability to have or keep an erection, or loss in sexual ability, desire, drive, or performance. These could be symptoms of sexual dysfunction. Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.