Back to main page

Antidepressant and anti-psychotic medication weight gain is no longer a mystery. It is a fact, it does happen, it has not been your imagination and you are not the only one having this happen to them.

If you are like most people fighting weight gain, you have probably tried several diets or several methods to lose the weight. Antidepressants such as Effexor, Paxil, Prozac, Effexor, Zoloft, Celexa, Cymbalta and Lexapro do cause rapid weight gain.

Anti-psychotics, such as Zyprexa and Risperdal do as well.

Before you continue reading, we want you to understand The Road Back is not a weight loss company and we do not sell supplements. We have been training physicians and assisting individuals with psychoactive medication side effects since 1999.  Weight gain is a side effect. We do not charge for our work.

What is Happening to Cause Weight Gain and Why Click here

What Can Be Done to Overcome Medication Induced Weight Gain? Click here

What is happening? Why does this happen? From the thousands of e-mails received over the years we do know: Diet and exercise alone will not make a difference. If anything, many of the diets promoted today create adverse reactions with your medication.

We also know many of you now crave foods and sweets like never before.

Statistics show once weight gain begins while taking these medications it usually does not stop. It is not odd to receive feedback from people that have gained 40 to 60 pounds in a short period of time.

This is an area The Road Back has been investigating and researching for several years. A common e-mail we receive is: "If I was not really depressed before I went on the antidepressant, I am now."

Below you will find out the reason and the solution.

The Reason For Weight Gain:
Antidepressants and anti-psychotics were created to alter an area of the brain called the Pituitary-Adrenal Axis (HPA). The HPA is a system of hormones and glands. The hormones within the HPA regulate serotonin.

These medications are designed to increase the output of a hormone that is believed to lower stress, depression and symptoms associated with mental disorders.

This HPA system has a group of steroid hormones called Glucocorticoids, which regulate carbohydrate, protein, and fat metabolism.

This HPA system needs to be in balance for the body to function properly.

The human brain will usually make up 2% of our overall body mass. However, our brain will use up 50% of glucose in the body. The brain depends on our glucose for energy.

Activity within this system generates messages of “energy on demand” and “energy on request.”

The activation of the adrenal system inhibits glucose uptake by tissue by inhibiting insulin release. This process produces insulin resistance but increases hepatic glucose production.

With inadequate “energy on request,” a condition called neuroglycopenia (a shortage of glucose in the brain, also hypoglycemia.)

Symptoms associated with this condition:

A decrease in brain glucose will activate other portions of the brain that release proteins, which stimulate food intake.

When this happens, an increase in body weight is inevitable at this point.

The increase in fat mass will generate a feedback signal to other hormones and insulin.

These phenomena can also take place with prolonged stress, starvation, and continued heavy exercise, drugs or by certain chemicals.

This results in the permanent activation of the feedback signal, which results in continued insulin resistance, hypertension and metabolic syndrome.

This is why individuals that are predisposed to diabetes are 2 to 3 times more likely to become diabetic if they use an antidepressant or anti-psychotic medication.

Another key hormone regulating weight that is also altered by glucocorticoid is leptin.

There are two types of leptin, brain leptin and plasma leptin.

Glucocorticoids increase both appetite as well as brain leptin secretion. Plasma leptin will store unwanted fats.

The brain is the controlling factor in this system. The brain knows it needs an ample supply of glucose to survive. With this balanced system being altered with drug induced over stimulation of glucocorticoid, the brain sends a signal to increase plasma leptin for fat and glucose storage. This insures the brain of the needed glucose for survival.

This increased plasma leptin works for the brain effectively in the short-term but ultimately leads to the destruction of the body. Obesity, diabetes, and a hormone – gland system that becomes too fatigued to function, is the final outcome.

The human brain is remarkable and highly complex. But when it is threatened with survival, the automatic reaction is self-destructive. 

Sleep:
If you are having a difficult time with sleep, it is also important to address and handle that issue as well. Sleep deprivation increases these key hormones in the afternoon and early evening. During these times of the day you will have an increased production of these hormones.

Chronic sleep loss is directly associated with carbohydrate intolerance, similar to that observed with impaired glucose intolerance. Chronic sleep loss is directly related to the increased risk of diabetes.

There is a remarkable correlation between the increase in hunger and the increase of brain protein and leptin ratio. The brain regulation of appetite and food intake is influenced by sleep duration, restriction of sleep and the development of obesity.

What Can Be Done to Overcome Medication Induced Weight Gain?

You can begin to take back control of your body. Putting these hormones back in balance and regulating leptin, glucose and insulin is the key.

If you are still taking an antidepressant or anti-psychotic it is also vital you do not alter the medication metabolism or you would create side effects.

Introducing back into the body specific nutritionals, made from a natural food source, is essential.

The Road Back does not sell nutritionals.

Where to find the nutritionals we recommend:
The weight loss combination we recommend is supplied by TRB Health Click here, 866-810-3809.
If you are in or near Houston, Texas, American Health Food - 10944 Westheimer, Houston, TX. Telephone - 713-785-4130 stocks the TRB Health products.

To stop weight gain and to lose weight, we recommend the following nutritionals:

·         Power Barley Formula

·         Ultimate Omega 3

·         CLA

·         Essential Protein Formula

·         Coconut oil

·         Body Calm capsules (For sleep if needed)

You should be able to at find the coconut oil at your local health food store with ease. Extra virgin coconut oil is ideal.

The other nutritionals are only sold by TRB Health.

What to take and how much to take:

·         1 tablespoon of coconut oil each day. Take anytime before 6 PM. Mix with food if desired.

The coconut oil will help regulate the
glucocorticoid hormone that is the initial and persistent cause of the weight gain.

·         3 Ultimate Omega 3 first thing in the morning and 3 Ultimate Omega 3 at noon.

With Ultimate Omega 3 being high in EPA, it will work hand-in-hand with CLA to regulate leptin.

·         1 CLA softgel first thing in the morning, 1 CLA softgel at noon and 1 CLA softgel at 3 PM.

This type of CLA is made from pure safflower oil and has the structure to not only promote weight loss but to regulate the hormone leptin. Only take CLA if using Ultimate Omega 3.

·         1 teaspoon of Essential Protein Formula first thing in the morning, 2 teaspoons at noon, 1 teaspoon around 4 PM and 1 teaspoon at bedtime.

The Essential Protein Formula will help your body regulate glucose, insulin, give a nice smooth energy, and help relieve stress. This formula is also filled with the right type of carbohydrates, good fats, oils and protein that will actually breakdown and assimilate within the body.

·         1 teaspoon of Power Barley Formula first thing in the morning.

If you have never used green foods, you are in for a treat. The Power Barley Formula will help jumpstart your metabolism in the morning, help regulate leptin, give a nice boost of energy, begin to clean the blood of toxins, gently begin to clean the liver, and provide a balanced source of minerals and vitamins.

* You can mix the Essential Protein Formula in with the Power Barley Formula and have a drink with a nice vanilla taste.

·         Sleep and or Anxiety (If needed). 1 Body Calm capsule at bedtime for sleep.
For anxiety – 1 Body Calm capsule first thing in the morning, 1 capsule every 4 hours throughout the day and 1 capsule at bedtime.

Body Calm and the Essential Protein Formula are the nutritionals used to taper off a benzodiazepine. These two nutritionals handle the common benzodiazepine side effect anxiety and insomnia with ease. 

The above suggestions are ideal.

If your budget is a concern, begin with the Ultimate Omega 3 and CLA. TRB Health has agreed to offer a discount when someone purchases Ultimate Omega 3 and CLA together. TRB Health calls this a Swift Start Package.

What you should expect:
If you are still gaining weight each week the first change will be the weight gain stopping. Usually within the next week weight loss usually begins.

If you have anxiety or insomnia make sure you get at least the Body Calm capsules.

If you are suffering from fatigue the Power Barley Formula is the answer. You can take it as often as 3 times a day if needed.

If you need or want a meal replacement, the Essential Protein Formula has all the nutrients for an effective meal replacement. If you are craving sweets, the Essential Protein Formula is a must.

References:

·          "These studies suggest that the fat-cell derived hormone Leptin might play an important role. Leptin signals to the brain the size of the adipose tissue and is probably the most important peripheral signal for the long-term regulation of weight." Neurol Psychiatry

·          "Leptin, a hormone secreted from adipose tissue, was originally discovered to regulate body weight. The localization of the leptin receptor in limbic structures suggests a potential role for leptin in emotional processes. Here, we show that rats exposed to chronic unpredictable stress and chronic social defeat exhibit low leptin levels in plasma. Systemic leptin treatment reversed the hedonic-like deficit induced by chronic unpredictable stress and improved behavioral despair dose-dependently in the forced swim test (FST), a model widely used for screening potential antidepressant efficacy. The behavioral effects of leptin in the FST were accompanied by increased neuronal activation in limbic structures, particularly in the hippocampus. Intrahippocampal infusion of leptin produced a similar antidepressant-like effect in the FST as its systemic administration. By contrast, infusion of leptin into the hypothalamus decreased body weight but had no effect on FST behavior. These findings suggest that: (i) impaired leptin production and secretion may contribute to chronic stress-induced depression-like phenotypes, (ii) the hippocampus is a brain site mediating leptin's antidepressant-like activity, and (iii) elevating leptin signaling in brain may represent a novel approach for the treatment of depressive disorders." January 31, 2006 the Department of Pharmacology, University of Texas Health Science Center

·          Massachusetts General Hospital, Clinical Psychopharmacology Unit, Boston 02114, USA.
"Weight gain is associated with the use of many psychotropic medications, including lithium, valproic acid, and several conventional and newer anti-psychotics. Patients asked to select from among several comparable drugs often choose the one least likely to cause weight gain, even if the drug is less effective or has other troublesome adverse effects. For many patients, weight gain is so intolerable that they discontinue treatment. Patients who continue treatment are at risk for clinically significant weight gain that can progress to obesity. Even after patients stop taking the drug, weight gained during therapy may be difficult to lose. Thus, the best approach is to attempt to prevent weight gain when feasible, possibly through pretreatment dietary counseling and judicious drug selection, and to intervene as soon as weight gain becomes evident."

·          The Journal of the American Medical Association - JAMA - Recombinant Leptin for Weight Loss in Obese and Lean Adults A Randomized, Controlled, Dose-Escalation Trial
"Conclusions A dose-response relationship with weight and fat loss was observed with subcutaneous recombinant leptin injections in both lean and obese subjects. Based on this study, administration of exogenous leptin appears to induce weight loss in some obese subjects with elevated endogenous serum leptin concentrations. Additional research into the potential role for leptin and related hormones in the treatment of human obesity is warranted."

·          Neurol Psychiatry 2001
"Weight changes during pharmacological treatment are a well-known phenomenon and they have been an object of research since the 1950's. Weight gain occurs during treatment with drugs of different chemical structures and is an important problem when patients are treated with antidepressants, antipsychotics, or mood stabilizers. The clinical relevance of drug-induced weight changes is due to increased rates of morbidity and reduced treatment compliance. Regarding the underlying causes, the important role of neurotransmitter systems and in particular the blockade of serotonin and histamine receptors has been discussed since decades. Only recently, however, research has been started on the effects of psychotropic agents on major neuroendocrine systems involved in appetite and weight regulation. These studies suggest that the fat-cell derived hormone leptin might play an important role. Leptin signals to the brain the size of the adipose tissue and is probably the most important peripheral signal for the long-term regulation of weight. In addition to the neuroendocrine systems, weight gain induced by psychotropic agents might also involve immune modulators, in particular the proinflammatory cytokine tumor-necrosis-factor-alpha (TNF-alpha) and soluble TNF-receptors. Some psychotropic agents influence the TNF system very rapidly, already prior to any obvious increases in weight. Hence, changes in the TNF-alpha system might be of predictive value for drug-induced weight gain. Strategies to minimize or to counteract weight gain induced by psychotropic agents include psychotherapeutic and pharmacological approaches. Although numerous psychotherapeutic approaches are available, they are only of limited usefulness in severely ill psychiatric patients. Fortunately, a number of promising pharmacological approaches to reduce weight have been introduced into clinical practice during the last years; however, so far there is no knowledge on pharmacodynamic and -kinetic interactions with psychotropic drugs, and there is no clinical data on the usefulness and safety of such drug combinations."

·          Department of Neuroscience, College of Medicine, University of Florida, McKnight Brain Institute, Gainesville, Florida
"Ghrelin stimulates and leptin inhibits appetite by modulating neuropeptide Y (NPY) signaling in the hypothalamus. Analysis of plasma ghrelin and leptin by sensitive radioimmunoassays showed that the two peripheral hormones are secreted in pulsatile fashion in rats consuming ad libitum rat chow. Fasting augmented all parameters of ghrelin pulsatile secretion and diminished leptin secretion by selectively attenuating the pulse amplitude; concomitantly it produced synchrony in ghrelin and leptin pulse discharge. These studies imply that a synchronous leptin restraint and ghrelin stimulus on NPYergic signaling may underlie robust appetitive drive."

·          EFA Sciences LLC, Norwood, Massachusetts
"Obesity may be a low-grade systemic inflammatory disease. Overweight and obese children and adults have elevated serum levels of C-reactive protein, interleukin-6, tumor necrosis factor-alpha, and leptin, which are known markers of inflammation and closely associated with cardiovascular risk factors and cardiovascular and non-cardiovascular causes of death. This may explain the increased risk of diabetes, heart disease, and many other chronic diseases in the obese. The complex interaction between several neurotransmitters such as dopamine, serotonin, neuropeptide Y, leptin, acetylcholine, melanin-concentrating hormone, ghrelin, nitric oxide, and cytokines and insulin and insulin receptors in the brain ultimately determines and regulates food intake. Breast-feeding of more than 12 mo is associated with decreased incidence of obesity. Breast milk is a rich source of long-chain polyunsaturated fatty acids (LCPUFAs) and brain is especially rich in these fatty acids. LCPUFAs inhibit the production of proinflammatory cytokines and enhance the number of insulin receptors in various tissues and the actions of insulin and several neurotransmitters. LCPUFAs may enhance the production of bone morphogenetic proteins, which participate in neurogenesis, so these fatty acids might play an important role in brain development and function. It is proposed that obesity is a result of inadequate breast feeding, which results in marginal deficiency of LCPUFAs during the critical stages of brain development. This results in an imbalance in the structure, function, and feedback loops among various neurotransmitters and their receptors, which ultimately leads to a decrease in the number of dopamine and insulin receptors in the brain. Hence, promoting prolonged breast feeding may decrease the prevalence of obesity. Exercise enhances parasympathetic tone, promotes antiinflammation, and augments brain acetylcholine and dopamine levels, events that suppress appetite. Acetylcholine and insulin inhibit the production of proinflammatory cytokines and provide a negative feedback loop for postprandial inhibition of food intake, in part, by regulating leptin action. Statins, peroxisome proliferator-activated receptor-gamma binding agents, non-steroidal antiinflammatory drugs, and infant formulas supplemented with LCPUFAs, and LCPUFAs themselves, which suppress inflammation, may be beneficial in obesity."

·          Additional References:

Division of Endocrinology, Department of Medicine, Harvard Medical School
Glucocorticoids reverse leptin effects on food intake and body fat in mice without increasing NPY and mRNA.

Department of Medicine, University of Tennessee College of medicine.
Inhibition of cortisol biosynthesis decreases circulating leptin levels in obese humans.

Division of Endocrinology, Diabetes and metabolism, Washington University School of Medicine.
Hormonal regulation of human leptin in vivo; effects of hydrocortisone and insulin.

University of Milan
Effect of small dose of dexamethasone on plasma leptin levels in normal obese subjects; a dose-response study.

Laboratory of Physiology, University Libre de Bruxelles
Metabolic and endocrine effects of sleep deprivation.

Concept Therapeutics, Menlo Park, CA.
The efficacy of mifepristone in the reduction and prevention of olanzapine-induced weight gain in rats.

Neurobiology Division, Department of Cell and Molecular Biology, Tulane University, New Orleans
Rapid glucocorticoid actions in the hypothalamus as a mechanism of homeostatic integration.


Top of page