PDF(Pubmed)
Abstract：
Research on antidepressant-related weight changes over more than 12 months is scarce and adjustment for the effects of depressive episodes has rarely been applied. Accordingly, our aim was to assess the associations of the use of any antidepressants, subclasses of antidepressant and specific compounds prior to baseline and during a 5.5-year follow-up with changes in adiposity markers, and the effect of sex on these associations, with adjustment for multiple confounders including the effects of depressive episodes and their severity. Data stemmed from a prospective cohort study including 2479 randomly selected 35-66 year-old residents of an urban area (mean age 49.9 years, 53.3% women) who underwent physical and psychiatric evaluations at baseline and follow-up. Weight, height, waist circumference, and body fat were measured by trained nurses and information on diagnosis and antidepressant use prior to baseline and during follow-up was collected through standardized interviews. In the fully adjusted models, the number of antidepressants, mainly SSRIs and TCAs, used prior to baseline, was associated with a lower increase of body-mass index (BMI, β (95%CI) = -0.12 (-0.19, -0.05)) and waist circumference (β = -0.28 (-0.56, -0.01)), whereas participants treated with antidepressants during the follow-up had a steeper increase in BMI (β = 0.32 (0.13, 0.50)) and waist circumference (β = 1.23 (0.44, 2.01)). Within the class of SSRIs, the use of fluoxetine, sertraline or escitalopram during follow-up was associated with a steeper increase in adiposity markers. The associations of SSRIs with BMI and waist circumference were only observed when the SSRIs were used during the second period of the follow-up. Sex did not moderate these associations. Our findings suggest an increase of adiposity markers during sustained treatment with TCAs and SSRIs, which however return to normal levels after cessation of treatment. Hence, the benefit of long-term administration of these antidepressants should be carefully weighed against the potential risk of weight gain.
摘要：
对超过12个月的抗抑郁药相关体重变化的研究很少，并且很少对抑郁发作的影响进行调整。因此，我们的目的是评估使用任何抗抑郁药的关联，在基线之前和5.5年随访期间，随着肥胖标志物的变化，抗抑郁药和特定化合物的亚类。以及性别对这些关联的影响，调整多种混杂因素，包括抑郁发作的影响及其严重程度。数据来自一项前瞻性队列研究，包括2479名随机选择的35-66岁城市居民（平均年龄49.9岁，53.3％的女性）在基线和随访时接受了身体和精神病学评估。重量,高度,腰围,由训练有素的护士测量体脂,并通过标准化访谈收集基线前和随访期间的诊断和抗抑郁药使用信息.在完全调整的模型中，抗抑郁药的数量，主要是SSRIs和TCA，在基线之前使用，与较低的体重指数增加相关(BMI，β（95CI）=-0.12（-0.19，-0.05））和腰围（β=-0.28（-0.56，-0.01）），而在随访期间接受抗抑郁药治疗的参与者的BMI(β=0.32(0.13,0.50))和腰围(β=1.23(0.44,2.01))增加较快.在SSRI类中，使用氟西汀，在随访期间，舍曲林或艾司西酞普兰与肥胖标志物的急剧增加有关。SSRIs与BMI和腰围的关联仅在随访的第二阶段使用SSRIs时观察到。性别并没有减轻这些关联。我们的研究结果表明，在TCA和SSRIs持续治疗期间，肥胖标志物增加，然而，在停止治疗后恢复到正常水平。因此，长期服用这些抗抑郁药的益处应与潜在的体重增加风险仔细权衡.
