Eight generally used antidepressants have been ranked by their weight acquire potential.
Outcomes of a giant observational examine confirmed small variations in short- and long-term weight change in sufferers prescribed one in every of eight antidepressants, with bupropion related to the bottom weight acquire and escitalopram, paroxetine, and duloxetine related to the best.
Escitalopram, paroxetine, and duloxetine customers had been 10%-15% extra more likely to acquire at the very least 5% of their baseline weight in contrast with these taking sertraline, which was used as a comparator.
Investigators famous that the extra clinicians and sufferers find out about how a selected antidepressant might have an effect on sufferers’ weight, the higher knowledgeable they are often about which antidepressants to prescribe.
“Sufferers and their clinicians usually have a number of choices when beginning an antidepressant for the primary time. This examine gives vital real-world proof relating to the quantity of weight acquire that must be anticipated after beginning a few of the commonest antidepressants,” lead writer Joshua Petimar, ScD, assistant professor of inhabitants drugs within the Harvard Pilgrim Well being Care Institute at Harvard Medical Faculty, Boston, stated in a press launch.
The findings had been printed on-line on July 1 within the Annals of Inner Medication.
Actual-World Knowledge
Although weight acquire is a generally reported aspect impact of antidepressant use and should result in treatment nonadherence and worse outcomes, there’s a lack of real-world knowledge about weight change throughout particular medicines.
Investigators used digital well being data from eight healthcare techniques throughout the USA spanning from 2010 to 2019. The evaluation included info on 183,118 adults aged 20-80 years who had been new customers of one in every of eight frequent first-line antidepressants. Investigators measured their weight at baseline and at 6, 12, and 24 months after initiation to estimate intention-to-treat (ITT) results of weight change.
At baseline, contributors had been randomly assigned to start sertraline, citalopram, escitalopram, fluoxetine, paroxetine, bupropion, duloxetine, or venlafaxine.
The most typical antidepressants prescribed had been sertraline, citalopram, and bupropion. Roughly 36% of contributors had a analysis of melancholy, and 39% had been identified with anxiousness.
Amongst selective serotonin reuptake inhibitors (SSRIs), escitalopram and paroxetine had been related to the best 6-month weight acquire, whereas bupropion was related to the least weight acquire throughout all analyses.
Utilizing sertraline as a comparator, 6-month weight change was decrease for bupropion (distinction, 0.22 kg) and better for escitalopram (distinction, 0.41 kg), duloxetine (distinction, 0.34 kg), paroxetine (distinction, 0.37 kg), and venlafaxine (distinction, 0.17 kg).
Escitalopram, paroxetine, and duloxetine customers had been 10%-15% extra more likely to acquire at the very least 5% of their baseline weight in contrast with sertraline customers.
Investigators famous little distinction in adherence ranges between medicines throughout the examine besides at 6 months, when it was increased for individuals who took bupropion (41%) than for these taking different antidepressants (28%-36%).
The examine included knowledge solely on prescriptions and investigators couldn’t confirm whether or not the medicines had been distributed or taken as prescribed. Different limitations included lacking weight info as a result of most sufferers didn’t encounter the well being system at precisely 6, 12, and 24 months, solely 15%-30% had weight measurements in these months.
Lastly, the low adherence charges made it troublesome to attribute relative weight change on the 12- and 24-month time factors to the precise medicines of curiosity.
“Clinicians and sufferers might contemplate these variations when making selections about particular antidepressants, particularly given the advanced relationships of weight problems and melancholy with well being, high quality of life, and stigma,” the authors wrote.
The examine was funded by the Nationwide Institute of Diabetes and Digestive and Kidney Ailments. Disclosures are famous within the authentic article.
…. to be continued
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