Reactions 1704, p6 - 2 Jun 2018
Antidepressant use contributes to
population weight gain
Widespread antidepressant use appears to contribute
to population weight gain within the UK, according to
findings of a cohort study published in the BMJ.
Data from the UK Clinical Practice Research Datalink
2014) were used to investigate the association
between antidepressant prescribing and bodyweight
gain in 136 762 men and 157 957 women in whom body
mass index (BMI) had been reported at least three times.
Rate ratios were estimated from a Poisson model
adjusted for variables including concurrent prescribing
of antiepileptics or antipsychotics, and dietary advice.
Overall, 22.4% of women and 13.0% of men were
prescribed antidepressants in 2004.
During over 1.8 million person-years of follow-up, the
incidence of new episodes of weight gain of 5% or more
was significantly higher in those prescribed
antidepressants than in those not prescribed
antidepressants (11.2 vs 8.1 per 100 person-years;
adjusted rate ratio [aRR] 1.21; 95% CI 1.19, 1.22;
p<0.001). The aRR was greater in year 2 of treatment
(1.46; 95% Ci 1.43, 1.49) and year 3 (1.48; 95% CI
1.45, 1.51). Mirtazapine was associated with the
greatest risk of weight gain (aRR 1.50; 95% CI;
1.45, 1.56). Although the risk of weight gain was
increased during the first six years of treatment, there
was no increased risk of weight gain during or after
In patients who had normal bodyweight initially, the
aRR for transition to overweight or obesity during
antidepressant treatment was 1.29 (95% CI 1.25, 1.34);
and in patients who were overweight initially, the aRR
for transition to obesity was similar (1.29; 95% CI
"Widespread utilisation of antidepressants may be
contributing to long term increased risk of weight gain at
population level. The potential for weight gain should be
considered when antidepressant treatment is indicated,"
said the authors.
"Until better tolerated drug treatments are available,
efforts should be focused not on reducing use of
antidepressants but on minimising the risk of weight
gain and other associated side effects," commented
Professor Alessandro Serretti, and Stefano Porcelli, from
the University of Bologna, Italy, in an accompanying
editorial published in the BMJ.
"Hopefully it will be
possible in the not too distant future to identify a genetic
predisposition and recognise those at higher risk before
treatment is started," they said.
1. Gafoor R, et al. Antidepressant utilisation and incidence of weight gain during
10 years’ follow-up: population based cohort study. BMJ 2018: No. 361, 23
May 2018. Available from: URL: https://doi.org/10.1136/bmj.k1951.
2. Serretti A, et al. Antidepressant induced weight gain. BMJ 2018: No. 361, 24
May 2018. Available from: URL: https://doi.org/10.1136/bmj.k2151.
Reactions 2 Jun 2018 No. 17040114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved