Along with the increase in mood after taking antidepressants, the weight begins to increase.
Photo: Anastasia OSIPOVA
In recent years, the demand for antidepressants has been growing worldwide. Modern research shows that such drugs can help not only in the treatment of depression. They are prescribed for a very common type of headache (the so-called tension headache), to reduce the risk of a second stroke, the threat of a heart attack in coronary disease. And also in a number of other cases.
Among the most widely used latest generation antidepressants are the SSRIs, selective serotonin reuptake inhibitors. When taking them, some patients eventually notice an unpleasant side effect. Along with the rise in mood, the weight begins to increase. Is this the inevitable payoff for improving one’s psychological state? Who is most likely to experience this effect? It can be avoided? We asked a neuroendocrinologist, candidate of medical sciences, associate professor of the endocrinology department of the RNIMU medical faculty to answer the questions. NI Pirogov Yuri Poteshkin.
FIRST we lose weight, then we improve
– SSRI drugs act on the serotonin system and many different receptors in the body, including appetite suppressants. Because of this, they should have the effect of reducing weight, the doctor explains. – When these drugs were developed and tested on animals, this is exactly what happened (ie, experimental animals lost weight. – Ed.). In addition, the effect was dose-dependent: the higher the dose, the lower the weight.
When antidepressants began to be used in medical practice, it turned out that at the beginning of taking SSRIs, as a rule, people lose weight. However, over time, the opposite effect appears. The stimulation of weight gain begins!
Because of what such a 180 degree turn occurs, scientists are not fully aware. The mechanism of action of antidepressants remains one of the medical mysteries, psychiatrist Artem Gilev told KP.
– If the indicators of people are tracked for years and even tens of years, it turns out that body weight increases by about 10 people out of 100 [людей, принимающих антидепрессанты группы СИОЗС]- says Yuri Poteshkin. – Whether this happens in a particular patient depends on many factors. Even from the course of the depression itself. The important thing is genetics.
If a person has a slow metabolism, then the drugs are inactivated longer, their concentration in the blood falls slowly, the expert explains. Against the background of such a delay of drugs in the body, the so-called resistance of the signaling system develops. That is, the receptors that previously effectively interacted with the drug begin to “shut down” from it. The number of receptors on the cells may decrease or the intracellular conductivity may change. The result of all these processes is weight gain.
QUESTION-EDGE
How to avoid weight gain?
Even before taking antidepressants of one group or another, today you can find out how they will be metabolized (that is, processed) in a particular patient. Including whether the drug will be delayed in the body, fraught with weight gain. This became possible due to the development of pharmacogenetics.
“You can take a genetic test and find out your own characteristics of the metabolism of antidepressants,” explains Yuri Poteshkin. – This allows for more personalized dosing and reduces the risk of side effects, including weight gain.
In general, if a person gains weight during treatment for depression, the following are used to combat excess weight:
– proper nutrition,
– regular physical activity,
– if necessary, the appointment of drugs for the treatment of obesity for medical reasons.
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