Starting an antidepressant, feeling like yourself again after months of fog, and then stepping on the scale to discover a number that doesn’t add up can cause a certain kind of frustration. That experience is more frequent than most pharmacists at the pickup counter for patients taking Celexa, the brand name for citalopram.
Celexa is a member of the group of drugs known as selective serotonin reuptake inhibitors, or SSRIs. The medication keeps more serotonin available to control mood, sleep, and overall mental stability by stopping the brain from reabsorbing it too quickly. For many people, it performs this function fairly well. However, the weight issue is more complicated.
There isn’t a single clear explanation offered by experts for why some patients gain weight when taking Celexa. A few working theories exist. One is that the medication slows metabolism, which causes the body to burn calories at a somewhat slower pace.
Another is that hunger signals can be triggered by high serotonin levels, giving people the impression that they haven’t eaten even though they have. The third possibility, which may be the most subtly ironic, is that when Celexa lifts depression, the appetite that depression had suppressed begins to resurface. People resume eating. That is typically an indication of healing. However, it can suddenly add pounds if it swings in the opposite direction.
According to research, the actual weight gain linked to Celexa is typically quite small, typically only a few pounds over the course of a year or two, and rarely more than six pounds for the majority of patients over an extended period of time. That doesn’t make it insignificant, particularly for someone who is already sensitive to issues related to body image. However, it does counter the concern that Celexa transforms everyone into a completely different body. The scale might move a little. Another possibility is that it doesn’t move at all.
The fact that depression itself affects weight long before any medication is involved complicates matters. Some depressed people give up eating. Some overindulge in food as a coping mechanism. They become less active, slow down, and cease moving in the same manner as before. When an antidepressant starts to work and some of those behaviors change, it can be very difficult to distinguish the effects of the medication from the consequences of the illness. The variables become hazy.
It’s obvious that stopping Celexa suddenly isn’t a sensible way to address the weight issue. Discontinuation syndrome, a collection of withdrawal symptoms including anxiety, mood swings, confusion, and disturbed sleep, can be brought on by abruptly stopping an SSRI. The best course of action is to speak with a prescriber rather than making the decision to quit on your own if the weight change feels substantial enough to warrant attention.
Although the conditions make it more challenging, controlling weight while taking Celexa is not significantly different from controlling weight in general. Research consistently demonstrates that people underestimate how much they’re eating, frequently by a surprising margin, so keeping a food journal tends to help—not as a form of punishment. Reducing sugar-filled beverages and processed carbohydrates is typically where those hidden calories first appear. Because insufficient sleep increases the hunger hormone ghrelin and makes it more difficult to resist cravings, sleep is more important than most people realize.
Exercise deserves its own mention. Physical activity is beneficial for depression on its own, not just because it burns calories. Walking for thirty minutes a day, swimming, cycling, taking a class, or doing anything else that gets done can help stabilize mood while counteracting some of the metabolic drag that the medication may cause. Even though it sounds like generic advice, doctors continue to recommend it for a reason.
A doctor may think about reducing the dosage or changing to a different antidepressant completely if the weight gain continues and is truly bothersome. Because bupropion, which is marketed under the Wellbutrin brand, tends to be more weight-neutral, it is occasionally used as a substitute. It’s not a decision that should be made solely on the basis of a scale number, and it’s not the best course of action for everyone. However, it’s a valid choice that merits discussion.
For some, Celexa weight gain is genuine; for others, it is exaggerated; and for many, it is completely absent. The truthful response, which doesn’t fit neatly on a pill bottle, is that it depends. Starting weight, metabolism, lifestyle, duration of drug use, and variables that researchers are still figuring out—such as genetic variations in how people absorb the drug—all play a role.
The science still has a lot of unanswered questions. It has been shown that most people can manage the issue without jeopardizing the progress in their mental health that led them to the medication in the first place, and that the issue is worth taking seriously without becoming overly dramatic.
