Aropax & Weight Loss
Aropax, a brand name of the drug paroxetine, is an SSRI-based antidepressant used to treat major depression, anxiety disorders or obsessive-compulsive disorders in adults. SSRIs, or selective serotonin reuptake inhibitors, increase serotonin levels in the brain; however, they are known to cause a wide variety of side effects. Aropax has been associated with weight gain, in contrast with other SSRIs like sertraline and fluoxetine, which do not cause weight gain.
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Side Effects
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If side effects of Aropax are a nuisance, other medicines may be prescribed. Aropax has both mental and physical side effects. Among the most typical are nausea, drowsiness or excess desire to sleep (somnolence), sexual side effects (e.g. problems ejaculating), sweating, dizziness, trouble sleeping (insomnia), tremors, constipation, constipation, physical weakness (asthenia), headaches and weight gain. Another side effect can be increased thoughts of suicide and suicidal behaviors, which is why Aropax is not approved by the U.S. Food and Drug Administration for use in children. In addition, stopping the use of Aropax can cause SSRI discontinuation syndrome and other adverse effects.
Initial Weight Loss
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Side effects such as nausea can lead to weight loss in the first four weeks of treatment. SSRIs are known to affect body weight. In the short term, this generally manifests itself as reduced appetite and, for some patients, a loss in body weight. Initially, patients report reduced appetite possibly as a result of nausea; in a 1999 study by Guy Chouinard, M.D., 3 percent of participants in the Aropax group experienced weight loss (compared with 12 percent in the fluoxetine group) during the initial period. However, more recent evidence suggests that initial weight loss under Aropax may be followed in the longer term by weight gain.
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Long-Term Weight Gain
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Long-term use of paroxetine has been associated with weight gain, not weight loss. More recent studies suggest that weight loss during the first weeks of administration for many SSRIs may be followed by weight gain, especially with Aropax. Aropax is the SSRI most commonly associated with weight gain. In a 2000 study, Aropax patients showed an average body weight increase of 3.6 percent after a period of 26 to 32 weeks, compared with less significant weight disturbances from other SSRIs (1 percent with sertraline and 0.2 percent with fluoxetine).
Considerations
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Weight gain is more likely over a long period for all SSRIs, especially Aropax, although studies suggest that weight gain can happen relatively quickly in the first four weeks of treatment. In an open study, a group of researchers found that after six weeks weight gain on Aropax was approximately 1 kilogram, compared to no weight change for depression treated without pharmacology. This suggests that the short-term weight loss can transition rapidly to weight gain.
Warning
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Other antidepressants, such as mirtazapine, have higher rates of weight gain than paroxetine. Immediate weight loss and long-term weight gain on SSRIs like Aropax depend on the individual. In general, changes in weight are reported in a relatively small subset of the population using Aropax, probably less than 15 percent. In addition, the long-term weight gain from Aropax use is probably at most 3 to 4 kilograms. Other antidepressants, such as mirtazapine (a tetracyclic antidepressant), have been shown to lead to even larger weight gains. Before switching from Aropax, analyze the weight changes associated with the prospective new drug first.
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References
- Fluoxetine versus Sertraline and Paroxetine in Major Depressive Disorder: Changes in Weight with Long-term Treatment; Fava M, Judge R, Hoog SL, Nilsson ME, Koke SC; Journal of Clinical Psychiatry, 61:863-7; 2000
- Effects of Antidepressants on Weight; Hinze-Selch, D, Schuld A, Kraus T, Kuhn M, Uhr M, et al.; Neruopsychopharmacology, 23:13-19; 2000
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