Medications that cause weight gain and alternatives in Canada: a narrative review

Figures & data

Table 1 Treatment-emergent weight changes associated with antipsychotics and mood stabilizers

Drug name	Weight effect
Aripiprazole^Citation15,Citation20,Citation29	−a
Carbamazepine^Citation33,Citation34,Citation37,b	− −a
Chlorpromazine^Citation18^–^Citation20	+ +
Clozapine^Citation11^–^Citation13	+ +a
Haloperidol^Citation20,Citation23,Citation24	+ +a
Iloperidone^Citation20,Citation24,Citation26	+a
Lamotrigine^Citation32,Citation34,Citation36,b	− −a
Lithium^Citation30^–^Citation33	+ +
Lurasidone^Citation20,Citation26,Citation28	Neutral
Olanzapine^Citation5,Citation13^–^Citation16	+ +a
Paliperidone^Citation20,Citation26,Citation27	+ & −a
Quetiapine^Citation20^–^Citation22	+ + & −
Risperidone^Citation13,Citation20,Citation24	+a
Sertindole^Citation13,Citation20,Citation25	+a
Valproic acid^Citation34^–^Citation36,b	+ +a
Ziprasidone^Citation13,Citation16,Citation20	−a

Notes: +=>1 kg. Neutral=±1 kg. −=<−1 kg. Additional + or − refers to >3 kg weight change.

a Articles cited included ≥1 weight neutral estimate(s).

b Anticonvulsant and mood stabilizer.

Table 2 Treatment-emergent weight changes associated with antidepressants

Drug name	Weight effect
Atypical
Bupropion (norepinephrine–dopamine reuptake inhibitor)^Citation5,Citation42,Citation47,Citation51,Citation66	−a
Mirtazapine (noradrenergic and specific serotonergic)^Citation5,Citation42,Citation71,Citation72	+a
Monoamine oxidase inhibitors
Isocarboxazid^Citation57,Citation58	−a
Phenelzine^Citation45,Citation49,Citation54,Citation55	+ +a
Tranylcypromine^Citation45,Citation49,Citation56	+ +a
Selective serotonin reuptake inhibitor
Citalopram^Citation42,Citation59^–^Citation61	+ +a
Escitalopram^Citation42,Citation60,Citation64	+a
Fluoxetine^Citation5,Citation41^–^Citation43,Citation48,Citation50,Citation61	−a
Fluvoxamine^Citation61^–^Citation63	+ & − −a
Paroxetine^Citation42,Citation61,Citation65	+a
Sertraline^Citation42,Citation61,Citation66,Citation67	−a
Serotonin–norepinephrine reuptake inhibitor
Desvenlafaxine^Citation68^–^Citation70	+ & −a
Duloxetine^Citation42,Citation64,Citation65	+a
Venlafaxine^Citation42,Citation52,Citation71,Citation72	+ & −a
Tricyclic antidepressant
Amitriptyline^Citation5,Citation39^–^Citation42	+ +a
Desipramine^Citation40,Citation41,Citation43	+a
Doxepin^Citation46^–^Citation49	+a
Imipramine^Citation39,Citation44,Citation45	+a
Nortriptyline^Citation39,Citation40,Citation42	+ +a
Trazodone^Citation50^–^Citation52	−a

Notes: +=>1 kg. Neutral=±1 kg. −=<−1 kg. Additional + or – refers to ≥3 kg weight change.

a Articles cited included ≥1 weight neutral estimate(s).

Table 3 Treatment-emergent weight changes associated with antihyperglycemics

Drug name	Weight effect
α-glucosidase inhibitors
Acarbose^Citation5,Citation77,Citation87,Citation105	−a
Glucagon-like peptide 1 receptor
Exenatide^Citation5,Citation100,Citation108,Citation109	− −
Liraglutide^Citation5,Citation91,Citation102	− −
Inhibitors of dipeptidyl peptidate-4
Alogliptin^Citation97^–^Citation100	Neutral
Linagliptin^Citation90,Citation100,Citation106,Citation107	−a
Saxagliptin^Citation100,Citation103^–^Citation105	−a
Sitagliptin^Citation100^–^Citation103	−a
Insulin ^Citation85,Citation86,Citation88,Citation118	+ +a
Insulin secretagogues
Meglitinides
Nateglinide^Citation5,Citation95,Citation96	Neutral
Repaglinide^Citation79,Citation89,Citation109,a	+a
Sulfonylurea drugs
Chlorpropamide^Citation84^–^Citation86	+ +
Gliclazide^Citation75,Citation80,Citation94	+ +a
Glimepiride^Citation5,Citation90^–^Citation93	+ & −a
Glyburide^Citation78,Citation88,Citation89	+ +a
Tolbutamide^Citation5,Citation76,Citation87	++
Insulin sensitizers
Biguanides
Metformin^Citation5,Citation75^–^Citation78	−
Thiazolidinedione
Pioglitazone^Citation5,Citation79^–^Citation81	+ +
Rosiglitazone^Citation78,Citation82,Citation83	+ +
SGLT2 inhibitors (or gliflozin)
Canagliflozin^Citation93,Citation110,Citation111	− −
Dapagliflozin^Citation112^–^Citation114	− −a
Empagliflozin^Citation115^–^Citation117	−

Notes: +=>1 kg. Neutral=±1 kg. −=<−1 kg. Additional + or − refers to ≥3 kg weight change.

a Articles cited included ≥1 weight neutral estimate(s).

Table 4 Treatment-emergent weight changes associated with antihypertensives

Drug name	Weight effect
Alpha-blockers
Clonidine^Citation155,Citation156	+a
Prazosin^Citation157,Citation158	Neutral
ACE inhibitors
Enalapril^Citation131^–^Citation133	− −a
Lisinopril^Citation124,Citation137,Citation138	−a
Perindopril^Citation134^–^Citation136	+ & − −a
Ramipril^Citation139^–^Citation141	−a
ARBs
Irbesartan^Citation161,Citation165,Citation166	Neutral
Losartan^Citation131,Citation163,Citation164	− −a
Olmesartan^Citation161,Citation162,Citation165	Neutral
Telmisartan^Citation159^–^Citation162	−a
Valsartan^Citation167^–^Citation169	+a
Beta-blockers
Acebutolol^Citation153,Citation154	Neutral
Atenolol^Citation143^–^Citation145	+ +a
Metoprolol^Citation148,Citation149	+a
Propranolol^Citation146,Citation147	+a
Timolol^Citation150^–^Citation152	−a
CCBs
Amlodipine^Citation170^–^Citation172	Neutral
Diltiazem^Citation173^–^Citation175	+a
Direct renin inhibitors
Aliskiren^Citation176^–^Citation178	Neutral
Diuretics
Chlorthalidone^Citation122,Citation125,Citation126,a	−a
Furosemide^Citation122,Citation123,Citation130 a	− −
Hydrochlorothiazide^Citation121^–^Citation124,a	−a
Indapamide^Citation127^–^Citation129,a	−a

Notes: +=>1 kg. Neutral=±1 kg. −=<−1 kg. Additional + or − refers to ≥3 kg weight change.

a Articles cited included ≥1 weight neutral estimate(s).

Abbreviations: ACE, angiotensin converting enzyme; ARB, angiotensin II receptor blocker; CCB, calcium channel blocker.

Table 5 Treatment-emergent weight changes associated with corticosteroids

Drug name	Weight effect
Cortisone^Citation187^–^Citation189	+ +
Prednisolone^Citation185,Citation186	+ +
Prednisone^Citation182^–^Citation184	+ +

Notes: +=>1 kg. Additional + refers to ≥3 kg weight change.

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