Table 6.6-1. Drugs contributing to weight gain and alternative treatment choices

Drug class

Drugs associated with weight gain

Alternatives (associated with weight loss or weight neutral)

Antihistamine agents

Diphenhydramine

Oxymetazoline

Antihyperglycemic agents

Insulin, TZDs, sulfonylureas, meglitinides

Metformin, GLP-1 analogues​, DPP-4 inhibitors, SGLT-2​ inhibitors, acarbose ​

Contraceptives​

Depo-medroxyprogesterone ​

Oral contraception, barrier methods

Antidepressants

– MAOIs: Phenelzine 

– TCAs: Amitriptyline, nortriptyline​, imipramine

– SSRIs/SNRIs: Paroxetine, ​citalopram, escitalopram, sertraline

– Atypical: Mirtazapine

Trazodone​, nefazodone, duloxetine, venlafaxine, desvenlafaxine, fluvoxamine (variable weight effect), bupropion

 

Antihypertensive agents

– Atenolol, metoprolol​, propranolol

 – Diltiazem

– Central alpha agonists: Clonidine​

– Diuretics

– ACEIs/ARBs

– Amlodipine​, felodipine, nifedipine

Antipsychotic agents, ​neuroleptic agents, mood stabilizers

Clozapine​, olanzapine, quetiapine, haloperidol, perphenazine, risperidone, lithium

Lamotrigine, aripiprazole, ziprasidone

Glucocorticoids

Prednisone, dexamethasone, prednisolone ​(in higher than physiologic doses)

Budesonide, NSAIDs

Anticonvulsant agents

Valproic acid, gabapentin, carbamazepine

Lamotrigine​, topiramate, phenytoin, levetiracetam

ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; DPP-4, dipeptidyl peptidase 4; GLP-1, glucagon-like peptide 1; MAOI, monoamine oxidase inhibitor; NSAID, nonsteroidal anti-inflammatory drug; SGLT-2, sodium-glucose cotransporter 2; SNRI, serotonin-norepinephrine reuptake inhibitor; SSRI, selective serotonin reuptake inhibitor; TCA, tricyclic antidepressant; TZD, thiazolidinedione.