Do antidepressants lead to weight-increase? Antidepressant therapy and long-term changes in body mass index, waist circumference and fat mass - A prospective, population-based study

TL;DR

This study examines how antidepressant use affects weight gain over five years in people with depression, finding that long-term use of certain antidepressants is linked to increased body mass.

Contribution

The study uniquely evaluates the combined effects of antidepressant use and depressive episodes on long-term weight changes using a large population-based cohort.

Findings

Prior use of antidepressants was associated with lower BMI increase, while ongoing use was linked to greater BMI and waist circumference increases.

SSRIs and TCAs used during follow-up were associated with increased fat mass and waist circumference.

The findings suggest that long-term use of SSRIs and TCAs may contribute to weight gain, highlighting the need to balance benefits and risks.

Abstract

The presentation will focus on long-term weight changes in patients with major depressive disorder who use antidepressants. Research studying weight change over periods of more than 12 months is scarce and the effects of depressive episodes and antidepressants on weight changes have rarely been assessed simultaneously. Using data of a prospective population-based CoLaus|PsyCoLaus study, data on the associations of antidepressant use prior to baseline and during a 5.5-year follow-up with changes in adiposity markers and multiple adjustments including for the effects of depressive episodes will be presented. The cohort included 2479 randomly selected 35 to 66 year-old white residents (mean age 49.9 years, 53.3% women) of an urban area who accepted the physical and psychiatric evaluations at baseline and follow-up (76.8% participation at the follow-up). Diagnostic information on mental disorders, treatment use including psychotropic drugs was elicited using a semi-structured interview. Independently of the effect of antidepressants used during the follow-up and the effects of depressive episodes, the number of any antidepressant compounds used prior to baseline was associated with lower increase of body mass index (BMI), whereas the use of antidepressants during the follow-up was associated with steeper increase in BMI and waist circumference. Within AD classes, the use of tricyclic AD (TCA) and selective serotonin reuptake inhibitor (SSRI) prior to baseline was associated with lower increase, the use of SSRI during follow-up was associated with steeper increases in BMI. Similarly, the use of SSRI prior to baseline was associated with lower increase, the use of TCA and SSRI during the follow-up was associated with steeper increase in waist circumference. Finally, the use of SSRI during follow-up was also associated with steeper increase in fat mass. The findings support unfavorable obesogenic effects of sustained treatment not only with TCAs but also with SSRIs, suggesting that the benefit of long-term administration of these AD classes should be carefully weighed against the potential risk of weight gain.

None Declared