title: Changes in body weight during pharmacological treatment of depression.
abstract: The risk of weight gain is an important determinant of the acceptability and tolerability of antidepressant medication. To compare changes in body weight during treatment with different antidepressants, body weight and height were measured at baseline and after 6, 8, 12 and 26 wk treatment with escitalopram or nortriptyline in 630 adults with moderate-to-severe unipolar depression participating in GENDEP, a part-randomized open-label study. Weight increased significantly more during treatment with nortriptyline compared to escitalopram. The weight gain commenced during the first 6 wk of nortriptyline treatment, reached on average 1.2 kg at 12 wk (0.44-point BMI increase), and continued throughout the 6-month follow-up period. Participants who were underweight at baseline gained most weight. Participants who were obese at baseline did not gain more weight during treatment. Weight gain occurred irrespective of whether weight loss was a symptom of current depressive episode and was identified as an undesired effect of the antidepressant by most participants who gained weight. There was little weight change during treatment with escitalopram, with an average increase of 0.14 kg (0.05-point BMI increase) over 12 wk of treatment. In conclusion, treatment with the tricyclic antidepressant nortriptyline was associated with moderate weight gain, which cannot be explained as a reversal of symptomatic weight loss and is usually perceived as an undesired adverse effect. While treatment with nortriptyline may be recommended in underweight subjects with typical neurovegetative symptoms, escitalopram is a suitable alternative for subjects at risk of weight gain.
authors: Institute of Psychiatry, King's College London, London, UK. rudolf.uher@kcl.ac.uk
authors: Rudolf
authors: R
authors: Uher
authors: Ole
authors: O
authors: Mors
authors: Joanna
authors: J
authors: Hauser
authors: Marcella
authors: M
authors: Rietschel
authors: Wolfgang
authors: W
authors: Maier
authors: Dejan
authors: D
authors: Kozel
authors: Neven
authors: N
authors: Henigsberg
authors: Daniel
authors: D
authors: Souery
authors: Anna
authors: A
authors: Placentino
authors: Robert
authors: R
authors: Keers
authors: Joanna M
authors: JM
authors: Gray
authors: Mojca Zvezdana
authors: MZ
authors: Dernovsek
authors: Jana
authors: J
authors: Strohmaier
authors: Erik Roj
authors: ER
authors: Larsen
authors: Astrid
authors: A
authors: Zobel
authors: Aleksandra
authors: A
authors: Szczepankiewicz
authors: Petra
authors: P
authors: Kalember
authors: Julien
authors: J
authors: Mendlewicz
authors: Katherine J
authors: KJ
authors: Aitchison
authors: Peter
authors: P
authors: McGuffin
authors: Anne
authors: A
authors: Farmer
mesh_terms: D000328:Adult; D000368:Aged; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects / Q000627:therapeutic use*; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects; D015283:Citalopram / Q000009:adverse effects / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009661:Nortriptyline / Q000009:adverse effects / Q000627:therapeutic use*; D009765:Obesity / Q000139:chemically induced; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D015430:Weight Gain / Q000187:drug effects; D015431:Weight Loss / Q000187:drug effects; D055815:Young Adult
chemical_list: D000929:Antidepressive Agents, Tricyclic; D015283:Citalopram; D009661:Nortriptyline; D017367:Selective Serotonin Reuptake Inhibitors