Trazodone (Desyrel) is a medication that is approved for the treatment of depression. It is classified as an atypical antidepressant that functions as a “SARI” (serotonin antagonist and reuptake inhibitor). In addition to inhibiting the reuptake of serotonin, it also blocks excess serotonin at various receptor sites. It is believed that the combined effect of reuptake and antagonism help decrease depression.

The drug has also been found to be beneficial among those with anxiety disorder as well as insomnia. Many doctors prescribe Trazodone to help those undergoing withdrawal from harder drugs like opioids to help the patient cope with dysphoria and insomnia. Like all antidepressants, Trazodone can have side effects, including that of weight gain.

Trazodone and Weight Gain

In clinical trials, there was a clear connection between taking Trazodone and gaining weight. In one study, those who took Trazodone for 6 weeks gained an average of 1.2 pounds. While this may not seem like a striking gain, many people take the drug for a longer duration than 6 weeks, potentially leading to continued weight gain. Many speculate that the weight gained on Trazodone is largely due to its sedating effect and tendency to increase appetite.

How Trazodone Causes Weight Gain: List of Possibilities

There are many factors that may contribute to weight gain on Trazodone. These include things like appetite changes, sedation, and slowed baseline metabolism. Keep in mind that these are only possibilities and aren’t necessarily proven.

  • Appetite increase: Many antidepressants have the potential to change a person’s appetite. Some people with depression don’t eat adequate amounts of food. When an antidepressant starts working, they realize that they should eat, and they gain some weight. Others believe the appetite increase has to do with neurochemical alterations being made by the drug and that even those who were eating properly prior to taking the medication may develop a bigger appetite.
  • Carbohydrate cravings: Some claim that Trazodone makes them crave carbohydrates. While this isn’t proven, it is possible that a medication functioning as a serotonin antagonist and reuptake inhibitor could increase carbohydrate cravings. Scientists know that there are clear links between serotonin production and eating carbohydrates. If you notice that you’re seeking out sugary foods, junk foods, and pastas – it could be due to taking this drug.
  • Drug interaction: Anyone who is taking another medication in addition to Trazodone may not realize that the two drugs may interact. In some cases, drugs interact synergistically to amplify a particular side effect like weight gain. Therefore if you are on another medication, it is possible that both are influencing you to pack on weight.
  • Fat storage: Some speculate that it is possible for the body’s fat-storage mechanisms to get altered when a person takes a drug. There is clear evidence for this as a result of taking antipsychotic medications. Trazodone may disrupt your body’s homeostatic processes, which may result in more fat storage than usual.
  • Hormone levels: Those who take this drug for an extended duration are more likely to experience drug-induced hormone changes. The changes in hormones may be subtle and gradual, but they can result in very real changes in weight. While this hasn’t been proven, many self-reports indicate that antidepressants “mine” certain hormones, making it easier to gain weight.
  • Improved taste: When certain people get depressed, food doesn’t seem to taste very good. When they become less depressed, they often experience an improved taste. In other words, things start to taste good again, leading them to eat full meals and seek out food. When this improved taste is coupled with an increased appetite, it makes it very easy to gain weight.
  • Motivational deficit: Some individuals may react to this drug by experiencing a drop in motivation. They may feel better or have their insomnia under control, but their motivation may plummet as a result of using Trazodone. This is largely due to the depressant effect the drug has on the nervous system.
  • Sedation: Trazodone is considered to be a relatively sedating antidepressant, which is why it’s often prescribed for insomnia. The sedation alone may be responsible for some degree of weight gain. If you take it and feel more sedated than usual, you may have a tough time getting as much physical exercise, which will reduce your metabolism.
  • Side effects: Other side effects from the medication can include sleepiness, fatigue, and feelings of tiredness. Those who experience fatigue and/or increased sleepiness will have a tough time getting sufficient exercise. They may become increasingly lazy because it’s too difficult to overcome the drug-induced lethargy. In some ways, the side effects can indirectly cause a person to experience weight gain.
  • Slow metabolism: Many antidepressants are thought to slow your baseline metabolism. This means that regardless of if you are eating a strict diet and getting proper exercise, you could experience a gain in weight. Some people have reportedly kept their diets and exercise the same while taking Trazodone and noticed that they gained some weight.
  • Social eating: When you’re less depressed, you’re more likely to engage in social activities. This generally includes going out to eat with friends. You may not realize it, but if you are eating out more, you’re consuming larger portions and (potentially unhealthy food). This increase in “social eating” makes it easy to gain weight.

Note: It is important to keep in mind that weight gain may be due to a combination of these possibilities. For example, a person taking the drug may experience sedation, an increased appetite, and a slowed metabolism resulting from the drug.

Factors that influence weight gain on Trazodone

It should be mentioned that there are many individual factors that may influence weight gain on Trazodone. These include things like: the dosage you are taking, personal factors (e.g. genetics, habits, etc.), the duration over which you took Trazodone, as well as whether you are taking any other medications.

1. Dosage

There are different types of Trazodone including immediate release and extended release tablets. Regardless of the variation of the drug you are taking, a higher dose makes it more likely that you’ll gain weight. A starting dose for the immediate release is generally 150 mg per day taken in divided doses. A starting dose for the extended release version is 150 mg taken once daily.

Someone taking 150 mg (a low starting dose) will be less likely to gain weight compared to someone taking a high dose. Anytime you increase your dose, you are increasing the likelihood that you are going to gain weight. When you double the dose, you are essentially doubling the likelihood that you’re going to gain weight.

This is due to the fact that at higher doses, side effects are more likely. When you take a high dose of Trazodone, you are giving it more control over your neurochemistry as well as physiological functioning. This makes it difficult for your body to maintain a healthy metabolism and normal appetite.

2. Individual factors

Many people do not realize that there is significant individual variation when it comes to experiencing weight gain on Trazodone. This is largely due to specific individual factors such as: stress level, exercise habits, dietary intake, genetics, baseline metabolism, physiology, and overall lifestyle. Be sure to evaluate whether you have stopped exercising, have experienced increased stress, or changed your dietary intake since you started taking Trazodone.

It is important to avoid placing full blame on the drug if you have changed certain aspects of your lifestyle. New tests like GeneSight are now being used to help people predict how much weight will be gained based on individual genetic biomarkers.

3. Time span

Over what duration have you been taking Trazodone? Individuals that have been taking this drug for a long period of time are more likely to gain weight than those who’ve taken it for a short term. Someone that’s been on the drug for a long term (e.g. years) has essentially allowed the drug to have more influence over their physiology. Over time, your physiology will become more altered as a result of using the drug.

The longer the duration over which you take this medication, the greater the extent of the alterations that will occur. Additionally, people that take the drug for a long term generally end up having to increase their dosage due to developing tolerance for a lower dose. The dose increase coupled with drug-induced physiological alterations over time can lead to weight gain.

4. Other medications

If you are taking other medications, it is important to consider that they may also be a direct cause of your weight gain. If you were taking the other drugs prior to Trazodone and didn’t gain any weight, maybe Trazodone is the primary culprit. However, it is always important to consider that other drugs could eventually cause weight gain when used over time. Additionally, it is possible that both Trazodone and the other drug are eliciting effects that lead to weight gain. The final possibility is that the two drugs have a synergistic interaction that leads to weight gain.

How much weight will you gain from Trazodone?

It is impossible to determine exactly how much weight you’ll gain on Trazodone. Assuming you end up gaining weight, some research suggests that you’ll gain between 1 and 2 pounds within the first 6 months of treatment. For most people, gaining this small amount of weight isn’t a very big deal. Many people believe that the antagonism effect that the drug has on various serotonin receptors essentially cancels out some of the weight gain that would occur if its mechanism of action were solely that of serotonin reuptake inhibition.

Will everyone gain weight while taking Trazodone?

No. There are some people that take this drug and end up losing weight, and many people who end up experiencing no change in weight. Although the drug does end up being sedating and can make some people feel fatigued or groggy, the effect of weight gain is thought to be canceled out by the antagonism at various 5-HT receptors. If the drug were to function solely as a serotonin reuptake inhibitor, it would likely lead to more weight gain.

Trazodone: Cost-Benefit Analysis

If you’ve been taking Trazodone and packed on some serious weight, it is important to conduct a cost-benefit analysis. You should determine whether the “costs” (e.g. weight gain) outweigh the “benefits” (e.g. degree to which the drug is helping). If you’ve gained a lot of weight and the drug doesn’t seem to be helping your depression, anxiety, or insomnia, you may want to consider switching medications and/or Trazodone withdrawal. If you’ve gained minimal weight and the drug seems to be working well, this would be an example of where the benefits outweigh the costs – which is what you want.

Did you gain weight while taking Trazodone?

If you have experienced weight gain from taking Trazodone, feel free to share your experience in the comments section below. It may help others to know how much weight you gained, the dosage you were taking, how long you had been taking the drug, as well as other possible factors that you believe may have contributed to the weight gain. If you have any other thoughts or theories as to what may have lead to an increase in weight from this drug, be sure to leave a comment.