Psychotropic drug considerations in depressed patients with metabolic disturbances.
Depression, obesity, diabetes mellitus, and the metabolic syndrome are conditions commonly treated in primary care. The prevalence of each condition separately does not explain the frequency of their co-occurrence. Depression may lead to or exacerbate these endocrine and metabolic conditions. Conversely, these medical conditions may lead to or exacerbate depression. Psychotropic drugs that treat depression may increase appetite with resultant weight gain. Rarely, such agents may be associated with weight loss. We review the potential for psychotropic drugs to alter body weight and provide a table as a guide to drug selection. Unless circumstances dictate otherwise, clinicians should select psychotropic drugs least likely to induce weight gain when treating depressed patients with obesity, diabetes mellitus, or the metabolic syndrome. Even drugs generally thought to be "weight neutral" may occasionally be associated with weight gain. Thus, alerting patients to this potential and due diligence form the cornerstone of weight management in the depressed patient.
Vieweg
W Victor R
WV
Psychiatry Service, Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Va, USA. vvieweg@visi.net
Levy
James R
JR
Fredrickson
Sonja K
SK
Chipkin
Stuart R
SR
Beatty-Brooks
Mary
M
Fernandez
Antony
A
Hasnain
Mehrul
M
Pandurangi
Anand K
AK
D003863:Depression / Q000150:complications / Q000188:drug therapy*; D003920:Diabetes Mellitus / Q000139:chemically induced*; D006801:Humans; D024821:Metabolic Syndrome / Q000139:chemically induced* / Q000150:complications; D009765:Obesity / Q000139:chemically induced* / Q000150:complications; D011619:Psychotropic Drugs / Q000009:adverse effects*; D015430:Weight Gain / Q000187:drug effects
D011619:Psychotropic Drugs