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Best Antidepressants


Best antidepressant for weight loss

Which antidepressant makes you lose weight? Bupropion (Wellbutrin) is the only one that clearly causes weight loss. In fact, its structure closely resembles that of diethylpropion, a proven appetite suppressant.

Antidepressants that do not cause weight gain are: venlafaxine (Effexor), duloxetine (Cymbalta), trazodone, and nefazodone (Serzone).

Antidepressants most likely to cause weight gain include [2]:

  • Tricyclic antidepressants, particularly amitriptyline, imipramine (Tofranil), and doxepin (Sinequan) - stimulate appetite, slow the metabolic rate and possibly increase carbohydrate cravings.
  • Paroxetine (Paxil) - more likely to cause weight gain than the other SSRIs (appears to have the most significant impact on weight gain of all of the SSRIs)
  • Mirtazapine (Remeron) - significant weight gain in short and long term.

Best antidepressant for anxiety

Escitalopram is effective and well-tolerated first-line option for panic disorder, generalized anxiety, social anxiety and OCD [4]. Also, escitalopram has a role in the treatment of resistant social anxiety.

Recent UK study showed that fluoxetine (in terms of response and remission) and sertraline (in terms of tolerability) are the optimal antidepressants for generalised anxiety disorder [3].

Best antidepressant for fatigue and low energy

Second only to depressed mood itself, tiredness, fatigue, low energy and motivation - are the most common symptoms of depression. Medications that increase norepinephrine and dopamine may restore energy more rapidly than others.

Bupropion, venlafaxine, fluoxetine and sertraline are the most activating antidepressants and may boost energy, motivation and eliminate fatigue.

Tianeptine (Stablon) is a neuroprotective antidepressant (selective serotonin reuptake enhancer) which elevates mood, enhances attention and memory [1]. Tianeptine is more stimulating than SSRIs and causes neither anxiety nor sedation. Unfortunately, it's not approved in the United States.

Antidepressant with fewest side effects

Escitalopram turns out to be the one with the fewest side effects. Sertraline, bupropion, and citalopram are also among better tolerated.

References:

  • 1. Zoladz PR, Park CR, Muñoz C, Fleshner M, Diamond DM. Tianeptine: an antidepressant with memory-protective properties. Curr Neuropharmacol. 2008 Dec;6(4):311-21
  • 2. Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010 Oct;71(10):1259-72.
  • 3. Baldwin D, Woods R, Lawson R, Taylor D. Efficacy of drug treatments for generalised anxiety disorder: systematic review and meta-analysis. BMJ. 2011 Mar 11;342. PubMed
  • 4. Pelissolo A. Efficacy and tolerability of escitalopram in anxiety disorders. Encephale. 2008 Sep;34(4):400-8.

Last Updated: September 2013



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