Does venlafaxine cause weight gain?

In this article:

• Venlafaxine weight gain
• Other factors that influence weight changes
• Tips for weight management
• Alternatives

In this article

• Venlafaxine weight gain
• Other factors that influence weight changes
• Tips for weight management
• Alternatives

Roughly 11.4% of Americans use a prescription medication to manage mental health conditions like depression and anxiety, according to the CDC. One common side effect of antidepressants is weight gain, affecting approximately 65% of patients. 

Effexor (venlafaxine) is an FDA-approved drug used to treat major depressive disorder, panic disorders, and anxiety disorders. While it can cause short-term weight loss, you might experience weight gain, especially with high doses or long-term use. 

Can venlafaxine cause weight gain?

Is it possible to gain weight on venlafaxine? Yes, especially with long-term use. Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI). It treats depressive disorders by blocking the reabsorption of norepinephrine and serotonin, which increases the availability of these neurotransmitters in the brain.

Researchers from Harvard Health note that weight gain is more likely to occur with extended use of venlafaxine. Taking an antidepressant for more than a year can lead to weight gain as your serotonin receptors become downregulated (desensitized). As a result, you may experience an increase in cravings and potential changes in your metabolism.

A cross-sectional study observed 362 patients who were taking an antidepressant drug for 6 to 36 months found that venlafaxine was among the drugs associated with weight gain.

“Higher dosages of venlafaxine can lead to an increase in desire for more food or comfort/sweet foods,” explains Erika Gray, Pharm.D., founder and chief medical officer at ToolBox Genomics.com. “Larger doses can stimulate dopamine pathways, which can cause people to crave more food through changes in their reward pathways.”

Is it possible to lose weight on the drug? 

Also, yes, particularly in the short term. Some patients may experience initial weight loss when starting an SNRI, due to increased satiety (a feeling of fullness). In a small study of 20 patients, researchers found that after one month on venlafaxine, patients experienced modest but statistically significant weight loss. 

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Other factors that influence weight changes

Fluctuations in weight are very personal; that is, there are several reasons you may gain weight on venlafaxine, and someone else may not.

“While venlafaxine is typically considered to be one of the more ‘weight-neutral’ SNRIs, meaning it doesn’t directly cause weight gain, being on venlafaxine could theoretically indirectly cause weight gain,” explains Saira Bhatti, MD, a psychiatrist based in New York, New York. “As an example, an individual with untreated depression may have little to no appetite, causing weight loss. Treating the depression by starting venlafaxine may stimulate their appetite as the depression improves and cause weight gain.”

In addition, there is a strong link between depression and obesity, as people who have depressive disorder are more likely to become obese. Even if you are treating depression with medication, you may still gain weight. This can be due to several factors, including:

• Lack of activity: People who are depressed may be less inclined to exercise
• Diet: Depression is linked to eating disorders that can lead to weight gain
• Medication side effects: Common side effects of venlafaxine include nausea, drowsiness, fatigue, and difficulty sleeping, all of which could affect exercise and diet 
• A slowed metabolism: Although this is seen mostly at higher dosages of venlafaxine, experiencing metabolic changes could lead to weight gain

6 ways to avoid weight gain on venlafaxine

If weight gain while taking venlafaxine or another antidepressant medication is a concern to you, there are several steps you can take to maintain a healthy body weight. 

1. Eat a diet high in fiber 

If you’re taking either an SNRI or a selective serotonin reuptake inhibitor (SSRI), you may experience changes in your metabolism. Fiber increases adiponectin in your body. Adiponectin is a hormone that regulates metabolism and improves insulin sensitivity, both of which are crucial for maintaining a healthy weight. 

2. Avoid sugary and processed foods

Long-term antidepressant use may lead to cravings for sweets. However, foods high in sugar and artificial ingredients add “empty” calories to your diet, meaning they are calories without nutritional benefit. Focus your diet on fruits, vegetables, and lean protein sources instead.

3. Follow an exercise routine

Exercise burns calories, which is an essential part of maintaining a healthy weight. The Centers for Disease Control and Prevention recommends 150 minutes of moderate activity every week, or five 30-minute workout sessions.

4. Get enough sleep

Many SNRIs, including venlafaxine, may initially disrupt your sleep. However, not getting enough sleep is linked to obesity. Experts recommend that adults get seven to nine hours of shut-eye each night.

5. Discuss your dosage

A starting dosage of venlafaxine is often 75 milligrams. Your provider may prescribe a higher dosage depending on your personal circumstances. In one study, nearly 30% of participants on dosages of 375 milligrams or higher per day reported weight gain. Be sure to discuss your treatment with your healthcare team if gaining weight is a concern for you.

6. Learn about non-medication therapies

Work with your healthcare provider to explore options to treat your depression. Combining treatment such as cognitive behavioral therapy with your prescription may keep your dosage low and avoid potential weight gain. 

Alternatives to venlafaxine

Certain types of antidepressants are linked to significant weight gain, including tricyclic antidepressants, monoamine oxidase inhibitors, and mirtazapine. If you’re looking for an alternative to venlafaxine without the weight gain, there are some options available depending on the class of drugs that may be best suited to your condition.

SNRIs

Venlafaxine is an SNRI, which means that it increases both serotonin and norepinephrine. These are often prescribed to people with low energy and even those who experience pain. If you’re seeking an SNRI alternative to venlafaxine, there are a few options that work similarly. 

“Pristiq (desvenlafaxine) has a decreased risk of weight gain and seems to stabilize blood sugars evenly. It is thought to be the most tolerable SNRI,” Dr. Erika Gray advises.

Another option is Cymbalta (duloxetine). Similar to venlafaxine, duloxetine may cause immediate weight loss but cause weight gain with long-term use. 

SSRIs

Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs used to treat anxiety and depression. These medications increase serotonin, but not norepinephrine, and are generally prescribed to people who would benefit from mood regulation. Some popular SSRIs include Prozac (fluoxetine), Zoloft (sertraline), Celexa (citalopram), and Lexapro (escitalopram). 

Researchers have found modest weight gain (3 to 4 pounds) with sertraline and escitalopram after two years of use. Citalopram and fluoxetine are not directly associated with weight gain.  

Paxil (paroxetine) is another SSRI, though it has been shown to be one of the medications most likely to cause weight gain in the short- and long-term.

NDRIs

Norepinephrine-dopamine reuptake inhibitors (NDRIs) such as Wellbutrin (bupropion) increase the levels of dopamine and norepinephrine in the brain and have little effect on serotonin. For that reason, these drugs tend to have little to no effect on body weight. 

“The most tolerated depression medication for minimizing weight gain is an atypical antidepressant non-SSRI called Wellbutrin (bupropion),” explains Dr. Erika Gray. “It can work well for people who lack energy and motivation, but some people report worsening anxiety.”

Researching common antidepressants on your own is a great start to finding the right drug for you. However, it is always advisable to consult a healthcare professional for personalized medical advice. Underlying conditions, lifestyle choices, and numerous other factors can determine which medication is most effective and which may put you at an increased risk of an adverse event.