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 (2004–2014) 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 year 7. 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 1.25, 1.33). "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. 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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