Cheskin L J, Bartlett S J, Zayas R, Twilley C H, Allison D B, Contoreggi C
Department of Medicine, Johns Hopkins University School of Medicine, and Johns Hopkins Bayview Medical Center, Baltimore, MD 21224, USA.
South Med J. 1999 Sep;92(9):898-904. doi: 10.1097/00007611-199909000-00009.
While usually not the only factor in obese patients, prescription medications, which may increase appetite or body weight, can be important in some individuals. The cause of weight gain in such cases may go unrecognized or lead to cessation of medication with or without the practitioner's knowledge or approval.
We found illustrative cases among patients treated at the Johns Hopkins Weight Management Center, searched MEDLINE and the Micromedex Drug Information database, and organized this information by drug mechanism and indications for use.
Most reports of medication-induced weight gain are anecdotal or gleaned from clinical trials. Notable offenders include hormones (especially corticosteroids and insulinotropic agents), and psychoactive medications (especially tricyclic antidepressants, lithium, and some antipsychotics).
Medication-related increases in appetite and body weight are under-recognized and cause noncompliance with pharmacotherapy. A high index of awareness of the known mechanisms by which medications can lead to weight gain has the potential to prevent most medication-related contributions to weight gain and obesity.
虽然在肥胖患者中，处方药物通常并非导致肥胖的唯一因素，但那些可能增加食欲或体重的药物，对某些个体而言可能是重要因素。在此类情况下，体重增加的原因可能未被识别，或者可能在医生不知情或未批准的情况下导致停药。
我们在约翰·霍普金斯体重管理中心治疗的患者中发现了一些典型病例，检索了MEDLINE和Micromedex药物信息数据库，并根据药物作用机制和使用指征对这些信息进行了整理。
大多数关于药物导致体重增加的报告都是轶事性的，或者是从临床试验中收集而来的。值得注意的药物包括激素（尤其是皮质类固醇和促胰岛素分泌剂）以及精神活性药物（尤其是三环类抗抑郁药、锂盐和某些抗精神病药物）。
与药物相关的食欲和体重增加未得到充分认识，并且会导致药物治疗依从性不佳。对药物导致体重增加的已知机制保持高度警惕，有可能预防大多数与药物相关的体重增加和肥胖问题。
