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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.