title: Body weight as a predictor of antidepressant efficacy in the GENDEP project.
abstract: BACKGROUND
  Being overweight or obese may be associated with poor response to antidepressants. The present report explores the moderation of antidepressant response by body weight to establish the specificity to antidepressant mode of action, type of depressive symptoms and gender.
  
  
  METHODS
  Height and weight were measured in 797 men and women with major depression treated with escitalopram or nortriptyline for twelve weeks as part of the Genome Based Therapeutic Drugs for Depression (GENDEP) project. Body mass index (BMI) and obesity (BMI>30) were tested as predictors of change in depressive symptoms using mixed linear models.
  
  
  RESULTS
  Higher BMI and obesity predicted poor response to nortriptyline but did not significantly influence response to escitalopram. The moderation of response by body weight was due to differential improvement in neurovegetative symptoms, including sleep and appetite. The relationship between body weight and change in neurovegetative symptoms was moderated by gender with obese men responding less to nortriptyline and obese women having poorer response to both antidepressants.
  
  
  CONCLUSIONS
  As no placebo arm was included, the specificity of findings to antidepressants is relative. Lack of specific measures precluded accounting for differences in body fat distribution.
  
  
  CONCLUSIONS
  Body weight should be considered in the assessment of depression as it may inform the selection of antidepressant treatment.
authors.affiliation: Institute of Psychiatry, King's College London, United Kingdom. rudolf.uher@iop.kcl.ac.uk
authors.forename: Rudolf
authors.initials: R
authors.lastname: Uher
authors.forename: Ole
authors.initials: O
authors.lastname: Mors
authors.forename: Joanna
authors.initials: J
authors.lastname: Hauser
authors.forename: Marcella
authors.initials: M
authors.lastname: Rietschel
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.forename: Dejan
authors.initials: D
authors.lastname: Kozel
authors.forename: Neven
authors.initials: N
authors.lastname: Henigsberg
authors.forename: Daniel
authors.initials: D
authors.lastname: Souery
authors.forename: Anna
authors.initials: A
authors.lastname: Placentino
authors.forename: Nader
authors.initials: N
authors.lastname: Perroud
authors.forename: Moica Zvezdana
authors.initials: MZ
authors.lastname: Dernovsek
authors.forename: Jana
authors.initials: J
authors.lastname: Strohmaier
authors.forename: Erik Roj
authors.initials: ER
authors.lastname: Larsen
authors.forename: Astrid
authors.initials: A
authors.lastname: Zobel
authors.forename: Anna
authors.initials: A
authors.lastname: Leszczynska-Rodziewicz
authors.forename: Petra
authors.initials: P
authors.lastname: Kalember
authors.forename: Laura
authors.initials: L
authors.lastname: Pedrini
authors.forename: Sylvie
authors.initials: S
authors.lastname: Linotte
authors.forename: Cerisse
authors.initials: C
authors.lastname: Gunasinghe
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Aitchison
authors.forename: Peter
authors.initials: P
authors.lastname: McGuffin
authors.forename: Anne
authors.initials: A
authors.lastname: Farmer
mesh_terms: D000328:Adult; D000339:Affect / Q000187:drug effects; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001066:Appetite / Q000187:drug effects; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D015283:Citalopram / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000235:genetics / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009661:Nortriptyline / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D009765:Obesity / Q000503:physiopathology / Q000523:psychology; D050177:Overweight / Q000503:physiopathology / Q000523:psychology; D012890:Sleep / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D015283:Citalopram; D009661:Nortriptyline