Gölbaşı Hasvak State Hospital, Department of Psychiatry, Ankara, Turkey.
Psychiatry Investig. 2013 Jun;10(2):148-54. doi: 10.4306/pi.2013.10.2.148. Epub 2013 May 30.
SSRIs are some of the most widely prescribed medications in the world. In addition to their effectiveness, SSRIs were reported to be associated with the side effects of weight gain, sexual dysfunction, drug interactions, extrapyramidal symptoms and discontinuation symptoms. However, the effects of SSRIs on metabolic parameters are poorly understood.
This study aims to describe the effects of SSRIs on the metabolic parameters of drug-naive first episode patients with generalized anxiety disorder. Ninety-seven female patients aged 20-41 years without any metabolic or psychiatric comorbidity were included in the study. Fluoxetine, sertraline, paroxetine, citalopram and escitalopram were randomly given to the patients. Metabolic parameters, including BMI, waist circumference and the levels of fasting glucose, total cholesterol, triglyceride, HDL, LDL and blood pressure, were measured before and after 16 weeks of treatment.
In the paroxetine group, there was a significant increase in the parameters of weight, BMI, waist circumference, fasting glucose, total cholesterol, LDL and triglyceride after 16 weeks of treatment. There were significant increases in the levels of triglyceride in the citalopram and escitalopram groups. In the sertraline group, the total cholesterol level increased after treatment. In the fluoxetine group, there were significant reductions in the parameters of weight, total cholesterol and triglyceride.
To our knowledge, this study is the first to prospectively describe metabolic syndrome abnormalities in patients with first episode generalized anxiety disorder. Although the effectiveness of the different SSRIs is similar, clinicians should be more careful when prescribing SSRIs to patients who have cardiac risk factors. Larger and lengthier controlled clinical trials are needed to explore the associations between SSRI use and metabolic syndrome.
SSRIs 是世界上应用最广泛的药物之一。除了疗效，SSRIs 还与体重增加、性功能障碍、药物相互作用、锥体外系症状和停药症状等副作用有关。然而，SSRIs 对代谢参数的影响仍不清楚。
本研究旨在描述 SSRIs 对初发广泛性焦虑症药物初治患者代谢参数的影响。纳入 97 名年龄在 20-41 岁之间、无任何代谢或精神合并症的女性患者。将氟西汀、舍曲林、帕罗西汀、西酞普兰和艾司西酞普兰随机给予患者。在治疗前和治疗 16 周后测量代谢参数，包括 BMI、腰围和空腹血糖、总胆固醇、甘油三酯、HDL、LDL 和血压水平。
在帕罗西汀组中，治疗 16 周后，体重、BMI、腰围、空腹血糖、总胆固醇、LDL 和甘油三酯等参数显著增加。西酞普兰组和艾司西酞普兰组的甘油三酯水平显著升高。舍曲林组总胆固醇水平升高。氟西汀组体重、总胆固醇和甘油三酯参数显著降低。
据我们所知，这项研究是首次前瞻性描述初发广泛性焦虑症患者代谢综合征异常。虽然不同 SSRIs 的疗效相似，但临床医生在为有心脏危险因素的患者开 SSRIs 时应更加小心。需要更大规模和更长时间的对照临床试验来探讨 SSRI 使用与代谢综合征之间的关系。
