Dataset Information

Antidepressant medication use, weight gain, and risk of type 2 diabetes: a population-based study.

ABSTRACT:

Objective

To examine antidepressant medication use as a risk factor for type 2 diabetes and weight gain.

Research design and methods

A series of nested studies within a prospective cohort of 151,347 working-aged men and women including 9,197 participants with continuing antidepressant medication, 224 with severe depression, and 851 with incident type 2 diabetes during a mean follow-up of 4.8 years, as indicated by national health and prescription registers (the Public Sector study, Finland 1995-2005).

Results

In the first analysis, the case subjects were individuals with incident type 2 diabetes compared with matched diabetes-free control subjects. Antidepressant use of ? 200 defined daily doses was associated with a doubling of diabetes risk in both participants with no indication of severe depression (odds ratio 1.93 [95% CI 1.48-2.51]) and participants with severe depression (2.65 [1.31-5.39]). In further analyses, the exposed group was antidepressant users and the reference group was nonusers matched for depression-related characteristics. The 5-year absolute risk of diabetes was 1.1% for nonusers, 1.7% for individuals treated with 200-399 defined daily doses a year, and 2.3% for those with ? 400 defined daily doses (P(trend) < 0.0001). An average self-reported weight gain, based on repeated surveys, was 1.4 kg (2.5%) among nonusers and 2.5 kg (4.3%) among users of ? 200 defined daily doses (P(trend) < 0.0001). Separate analyses for tricyclic antidepressants and selective serotonin reuptake inhibitors replicated these findings.

Conclusions

In these data, continuing use of antidepressant medication was associated with an increased relative risk of type 2 diabetes, although the elevation in absolute risk was modest.

SUBMITTER: Kivimaki M

PROVIDER: S-EPMC2992199 | biostudies-literature | 2010 Dec

REPOSITORIES: biostudies-literature

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Publications

Antidepressant medication use, weight gain, and risk of type 2 diabetes: a population-based study.

Kivimäki Mika M Hamer Mark M Batty G David GD Geddes John R JR Tabak Adam G AG Pentti Jaana J Virtanen Marianna M Vahtera Jussi J

Diabetes care 20100907 12

<h4>Objective</h4>To examine antidepressant medication use as a risk factor for type 2 diabetes and weight gain.<h4>Research design and methods</h4>A series of nested studies within a prospective cohort of 151,347 working-aged men and women including 9,197 participants with continuing antidepressant medication, 224 with severe depression, and 851 with incident type 2 diabetes during a mean follow-up of 4.8 years, as indicated by national health and prescription registers (the Public Sector study ...[more]

PMID: 20823343

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Project description:OBJECTIVE:To evaluate the long term association between antidepressant prescribing and body weight. DESIGN:Population based cohort study. SETTING:General practices contributing to the UK Clinical Practice Research Datalink, 2004-14. PARTICIPANTS:136?762 men and 157?957 women with three or more records for body mass index (BMI). MAIN OUTCOME MEASURES:The main outcomes were antidepressant prescribing, incidence of ?5% increase in body weight, and transition to overweight or obesity. Adjusted rate ratios were estimated from a Poisson model adjusting for age, sex, depression recording, comorbidity, coprescribing of antiepileptics or antipsychotics, deprivation, smoking, and advice on diet. RESULTS:In the year of study entry, 17?803 (13.0%) men and 35?307 (22.4%) women with a mean age of 51.5 years (SD 16.6 years) were prescribed antidepressants. During 1?836?452 person years of follow-up, the incidence of new episodes of ?5 weight gain in participants not prescribed antidepressants was 8.1 per 100 person years and in participants prescribed antidepressants was 11.2 per 100 person years (adjusted rate ratio 1.21, 95% confidence interval 1.19 to 1.22, P<0.001). The risk of weight gain remained increased during at least six years of follow-up. In the second year of treatment the number of participants treated with antidepressants for one year for one additional episode of ?5% weight gain was 27 (95% confidence interval 25 to 29). In people who were initially of normal weight, the adjusted rate ratio for transition to overweight or obesity was 1.29 (1.25 to 1.34); in people who were initially overweight, the adjusted rate ratio for transition to obesity was 1.29 (1.25 to 1.33). Associations may not be causal, and residual confounding might contribute to overestimation of associations. CONCLUSION: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.

Project description:ImportanceShort-term studies suggest antidepressants are associated with modest weight gain but little is known about longer-term effects and differences between individual medications in general clinical populations.ObjectiveTo estimate weight gain associated with specific antidepressants over the 12 months following initial prescription in a large and diverse clinical population.Design, setting, and participantsWe identified 22,610 adult patients who began receiving a medication of interest with available weight data in a large New England health care system, including 2 academic medical centers and affiliated outpatient primary and specialty care clinics. We used electronic health records to extract prescribing data and recorded weights for any patient with an index antidepressant prescription including amitriptyline hydrochloride, bupropion hydrochloride, citalopram hydrobromide, duloxetine hydrochloride, escitalopram oxalate, fluoxetine hydrochloride, mirtazapine, nortriptyline hydrochloride, paroxetine hydrochloride, venlafaxine hydrochloride, and sertraline hydrochloride. As measures of assay sensitivity, additional index prescriptions examined included the antiasthma medication albuterol sulfate and the antiobesity medications orlistat, phentermine hydrochloride, and sibutramine hydrochloride. Mixed-effects models were used to estimate rate of weight change over 12 months in comparison with the reference antidepressant, citalopram.Main outcome and measureClinician-recorded weight at 3-month intervals up to 12 months.ResultsCompared with citalopram, in models adjusted for sociodemographic and clinical features, significantly decreased rate of weight gain was observed among individuals treated with bupropion (β [SE]: -0.063 [0.027]; P = .02), amitriptyline (β [SE]: -0.081 [0.025]; P = .001), and nortriptyline (β [SE]: -0.147 [0.034]; P < .001). As anticipated, differences were less pronounced among individuals discontinuing treatment prior to 12 months.Conclusions and relevanceAntidepressants differ modestly in their propensity to contribute to weight gain. Short-term investigations may be insufficient to characterize and differentiate this risk.

Dataset Information

Antidepressant medication use, weight gain, and risk of type 2 diabetes: a population-based study.

Objective

Research design and methods

Results

Conclusions

Publications

Antidepressant medication use, weight gain, and risk of type 2 diabetes: a population-based study.

Similar Datasets

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