Drugs contributing to weight gain and alternative treatment choices

Table 6.5-1. 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.