title: Long-Term Weight Change after Initiating Second-Generation Antidepressants.
abstract: (1) OBJECTIVE: To examine the relationship between the choice of second-generation antidepressant drug treatment and long-term weight change; (2) METHODS: We conducted a retrospective cohort study to investigate the relationship between choice of antidepressant medication and weight change at two years among adult patients with a new antidepressant treatment episode between January, 2006 and October, 2009 in a large health system in Washington State. Medication use, encounters, diagnoses, height, and weight were collected from electronic databases. We modeled change in weight and BMI at two years after initiation of treatment using inverse probability weighted linear regression models that adjusted for potential confounders. Fluoxetine was the reference treatment; (3) RESULTS: In intent-to-treat analyses, non-smokers who initiated bupropion treatment on average lost 7.1 lbs compared to fluoxetine users who were non-smokers (95% CI: -11.3, -2.8; p-value < 0.01); smokers who initiated bupropion treatment gained on average 2.2 lbs compared to fluoxetine users who were smokers (95% CI: -2.3, 6.8; p-value = 0.33). Changes in weight associated with all other antidepressant medications were not significantly different than fluoxetine, except for sertraline users, who gained an average of 5.9 lbs compared to fluoxetine users (95% CI: 0.8, 10.9; p-value = 0.02); (4) CONCLUSION: Antidepressant drug therapy is significantly associated with long-term weight change at two years. Bupropion may be considered as the first-line drug of choice for overweight and obese patients unless there are other existing contraindications.
authors.affiliation: Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA. arterburn.d@ghc.org.
authors.forename: David
authors.initials: D
authors.lastname: Arterburn
authors.affiliation: University of Washington, UW Tower, 15th Floor, 4333 Brooklyn Ave NE, Seattle, WA 98105, USA. tsofer@uw.edu.
authors.forename: Tamar
authors.initials: T
authors.lastname: Sofer
authors.affiliation: Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA. boudreau.d@ghc.org.
authors.forename: Denise M
authors.initials: DM
authors.lastname: Boudreau
authors.affiliation: Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA. abogart@rand.org.
authors.forename: Andy
authors.initials: A
authors.lastname: Bogart
authors.affiliation: Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA. westbrook.e@ghc.org.
authors.forename: Emily O
authors.initials: EO
authors.lastname: Westbrook
authors.affiliation: Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA. theis.m@ghc.org.
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Theis
authors.affiliation: Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA. simon.g@ghc.org.
authors.forename: Greg
authors.initials: G
authors.lastname: Simon
authors.affiliation: Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA. shaneuse@hsph.harvard.edu.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Haneuse
keywords: adverse effects; antidepressant; depression; obesity; weight gain