The association between conventional antidepressants and the metabolic syndrome: a review of the evidence and clinical implications.
Major depressive disorder is a prevalent recurrent medical syndrome associated with inter-episodic dysfunction. The metabolic syndrome is comprised of several established risk factors for cardiovascular disease (i.e. abdominal obesity, dyslipidaemia, dysglycaemia and hypertension). The criterion items of the metabolic syndrome collectively represent a multi-dimensional risk factor for cardiovascular disease and type 2 diabetes mellitus. Extant evidence indicates that both major depressive disorder and the metabolic syndrome, albeit distinct, often co-occur and are possibly subserved by overlapping pathophysiology and causative mechanisms. Conventional antidepressants exert variable effects on constituent elements of the metabolic syndrome, inviting the need for careful consideration prior to treatment selection and sequencing. Initiating and maintaining antidepressant therapy should include routine surveillance for clinical and/or biochemical evidence suggestive of the metabolic syndrome.
McIntyre
Roger S
RS
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. roger.mcintyre@uhn.on.ca
Park
Ka Young
KY
Law
Candy W Y
CW
Sultan
Farah
F
Adams
Amanda
A
Lourenco
Maria Teresa
MT
Lo
Aaron K S
AK
Soczynska
Joanna K
JK
Woldeyohannes
Hanna
H
Alsuwaidan
Mohammad
M
Yoon
Jinju
J
Kennedy
Sidney H
SH
D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D024821:Metabolic Syndrome / Q000139:chemically induced / Q000150:complications* / Q000503:physiopathology; D012307:Risk Factors
D018687:Antidepressive Agents, Second-Generation
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