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Prescriptions that put on the pounds

Consumer Reports on Health: February 2010

Weight gain is an often overlooked side effect of many drugs. Some stimulate the appetite or slow the body’s metabolism. Others cause fluid retention or enough drowsiness to reduce physical activity and thus trigger weight gain.

Those effects can often be rapid and significant. Children and teenagers starting antipsychotic medication, for example, added an average of about 10 to 19 pounds after taking the pills for nearly 11 weeks, a 2009 study found.

So before starting a new drug, ask your doctor or pharmacist about its possible effect on weight. Exercising more and paying extra attention to diet might help minimize the problem of drug weight gain. If you find yourself putting on pounds while taking a medication, ask your doctor about switching to a lower dose or different drug. (Many of the drugs in the table below are also available as generics.)

Drug Possible weight gain Alternative drugs less likely to cause gain
ALLERGY DRUGS
Cetirizine (Zyrtec), diphenhydramine (Benadryl), fexofenadine (Allegra), and hydroxyzine (Vistaril)
1% or more Loratadine (Claritin) or desloratadine (Clarinex)
ANTIDEPRESSANTS
  • Selective serotonin reuptake inhibitors* such as fluoxetine (Prozac) and paroxetine (Paxil)
  • Tricyclic antidepressants such as amitriptyline and imipramine (Tofranil)
  • 10% or more
  • 5 to 10% or more
  • Bupropion (Wellbutrin) or escitalopram (Lexapro)
  • Desipramine (Norpramin)
BLOOD-PRESSURE DRUGS
Alpha-blockers such as prazosin (Minipress) and terazosin (Hytrin); beta-blockers such as atenolol (Tenormin) and propranolol (Inderal)
1 to 4% Guanfacine (Tenex)
DIABETES DRUGS
  • Sulfonylureas such as chlorpropamide (Diabinese) and glyburide (Glynase); thiazolidinediones such as pioglitazone (Actos) and rosiglitazone (Avandia)
5 to 10% or more Metformin (Glucophage)
SEIZURE AND NERVE-PAIN DRUGS
  • Gabapentin (Neurontin), pregabalin (Lyrica), and valproic acid (Depakote)
5 to 10% Topiramate (Topamax)
PSYCHIATRIC DRUGS
  • Clozapine (Clozaril) and olanzapine (Zyprexa)
  • Quetiapine (Seroquel) and risperidone (Risperdal)
  • 4 to 10%
  • 3 to 7%
Aripiprazole (Abilify) or ziprasidone (Geodon)
STEROIDS
  • Cortisone (Cortone), dexamethasone (Decadron), hydrocortisone (Cortef), and prednisone (Deltasone)
7% or more Various options depending on why the steroid was prescribed.
* Editor's Note: SSRIs may cause weight loss for the first few months.
   

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