Anti-depressants are having a bad decade. They've been increasingly implicated in acts of violence - it used to be that if a person had been treated by multiple therapists, society had done its part, and now society wonders if over-medicating and creating too many psychological labels are the problem rather than the solution.

Now antidepressants are increasingly linked to obesity. 

As detailed in JAMA Psychiatry, Sarah R. Blumenthal, B.S., Massachusetts General Hospital, Boston, and colleagues analyzed electronic health records from a large New England health care system to collect prescribing data and recorded weights for adult patients (age 18 to 65 years) prescribed one of 11 common antidepressants. The potential health consequences could be significant because more than 10 percent of Americans are prescribed an antidepressant at any given time, while obesity is associated with a host of medical conditions, including cardiovascular disease, type 2 diabetes and high blood pressure.

 The authors identified 22,610 adults - 19,244 adults treated with an antidepressant for at least three months and 3,366 who received a nonpsychiatric intervention. Compared with the antidepressant citalopram, patients treated with bupropion, amitriptyline and nortriptyline had a decreased rate of weight gain.

“Taken together, our results clearly demonstrate significant differences between several individual antidepressant strategies in their propensity to contribute to weight gain. While the absolute magnitude of such differences is relatively modest, these differences may lead clinicians to prefer certain treatments according to patient preference or in individuals for whom weight gain is a particular concern,” they write.

Citation: JAMA Psychiatry, June 4, 2014. doi:10.1001/jamapsychiatry.2014.414