title: Obesity, dyslipidemia, and diabetes with selective serotonin reuptake inhibitors: the Hordaland Health Study.
abstract: OBJECTIVE
  This study aimed to examine whether subjects taking selective serotonin reuptake inhibitors (SSRIs) are more likely to have elements of the metabolic syndrome compared with those taking no psychotropic drugs. For comparison, we also studied subjects taking antipsychotic drugs.
  
  
  METHODS
  We used data from The Hordaland Health Study '97-'99, a general community cross-sectional health survey including 25,315 subjects aged 40 to 49 and 70 to 74 years. For the groups studied, we estimated prevalence and odds ratios (ORs) for obesity, hypercholesterolemia, low high-density lipoprotein cholesterol, hyper-triglyceridemia, and diabetes.
  
  
  RESULTS
  We observed an association between use of SSRIs as a group (N = 461) and abdominal obesity (OR = 1.40, 95% CI = 1.08 to 1.81) and hypercholesterolemia (OR = 1.36, 95% CI = 1.07 to 1.73) after adjusting for multiple possible confounders. There was also a trend toward an association between SSRI use and diabetes. In a subgroup analysis of subjects taking SSRIs, the use of paroxetine (N = 187) was markedly associated with both general and abdominal obesity but not with hypercholesterolemia. In contrast, the use of citalopram (N = 142) was not associated with any of the metabolic outcome variables, while the use of any other SSRI (sertraline, fluoxetine, or fluvoxamine) (N = 131) as a mixed subgroup was associated with both abdominal obesity and hypercholesterolemia. We also replicated the previously reported associations between use of antipsychotics and obesity and metabolic disturbances.
  
  
  CONCLUSIONS
  We have shown that use of at least some SSRIs is associated with clinical and biochemical elements of the metabolic syndrome. Our data indicate differences in the metabolic side effect profile among various SSRI drugs, although treatment bias might have influenced these results. We suggest that patients taking SSRIs be carefully monitored for obesity and dyslipidemia.
authors.affiliation: Einar Martens' Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Helse Bergen HF, Norway. maria.rader@uib.no
authors.forename: Maria B
authors.initials: MB
authors.lastname: Raeder
authors.forename: Ingvar
authors.initials: I
authors.lastname: Bjelland
authors.forename: Stein
authors.initials: S
authors.lastname: Emil Vollset
authors.forename: Vidar M
authors.initials: VM
authors.lastname: Steen
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000139:chemically induced / Q000453:epidemiology*; D050171:Dyslipidemias / Q000139:chemically induced / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced / Q000453:epidemiology; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D009765:Obesity / Q000139:chemically induced / Q000453:epidemiology*; D016017:Odds Ratio; D015995:Prevalence; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors