Pharmacology
Pharmacology
Core68: Drug-induced adverse reaction: weight gain/loss
薬剤性有害反応：体重増加・減少
⚖️ High-yield / 要点：Drug-induced weight change happens through appetite effects, sedation, fluid retention, slowed metabolism, glucose loss, or reduced fat absorption.
Weight gain / 体重増加
| Group | Examples | Main mechanism |
|---|---|---|
| Diabetes drugs | Injectable insulin; sulfonylureas (glyburide, glipizide, glimepiride) | Weight gain especially early; combination with metformin may help |
| Antidepressants | SSRIs: paroxetine, sertraline, citalopram | Histamine/serotonin effects → increased appetite, carbohydrate craving |
| β-blockers | Atenolol, metoprolol, propranolol | Fluid retention, reduced metabolism, insulin resistance |
| Oral corticosteroids | Prednisone, methylprednisolone | Long-term effect on adipose tissue and glucose regulation |
| Anticonvulsants / mood stabilizers | Carbamazepine, valproic acid, lithium; TCAs such as amitriptyline, nortriptyline | Increased appetite, sedation, reduced metabolism |
| Antipsychotics | Olanzapine, quetiapine, risperidone, mirtazapine | Increased appetite and slower metabolism |
| Migraine drugs | Propranolol, divalproex sodium | Appetite increase, fluid retention, slowed metabolism |
| Antihistamines | Especially 1st generation | H1 blockade → appetite increase + sedation |
| Nerve pain drugs | Gabapentin, pregabalin | Appetite increase, slowed metabolism |
| Birth control | Depo-Provera | Often fluid-retention related |
Weight loss / 体重減少
| Group | Examples | Main mechanism |
|---|---|---|
| GLP-1 agonists | Semaglutide, tirzepatide, liraglutide | Increased satiety, reduced food intake, slower gastric emptying |
| SGLT2 inhibitors | Canagliflozin, dapagliflozin | Calorie loss through glycosuria; metabolic shift |
| Antidepressant combination | Bupropion + naltrexone | Reduced food craving, appetite suppression |
| Migraine preventive drugs | Topiramate, zonisamide, protriptyline | Appetite suppression, altered taste, increased energy expenditure |
| Lipase inhibitor | Orlistat | Prevents dietary fat absorption |
Remember / 覚え方
- Insulin, sulfonylureas, steroids, antipsychotics = weight gain
- GLP-1 agonists, SGLT2 inhibitors, topiramate, orlistat = weight loss
- Sedation can indirectly promote weight gain