Shi Zumin, Atlantis Evan, Taylor Anne W, Gill Tiffany K, Price Kay, Appleton Sarah, Wong Ma-Li, Licinio Julio
Adelaide Medical School, University of Adelaide, Adelaide, Australia.
School of Nursing and Midwifery, University of Western Sydney, Sydney, Australia.
BMJ Open. 2017 Aug 11;7(8):e016224. doi: 10.1136/bmjopen-2017-016224.
To examine the association between antidepressant use and weight gain, as well as the interaction with lifestyle factors.
Longitudinal study.
We used data from 2334 adults from two stages (4.4 years apart) of the North West Adelaide Health Study, including validated diet and lifestyle questionnaires, measured body weight and linked pharmaceutical prescription data.
Body weight change.
188 (8.1%) participants had a mean annual number of 1-2 antidepressant prescriptions, and 212 (9.1%) had over two prescriptions. The mean annual weight gain was 0.12, 0.18 and 0.28 kg in non-users, low (1-2 prescriptions/year) and high (>2 prescriptions/year) antidepressant users, respectively. In multivariable regression models, antidepressant use was positively associated with weight gain: high antidepressant users gained an extra 0.22 (95% CI 0.00 to 0.44) kg per year. This association was mainly due to selective serotonin reuptake inhibitor (SSRI) use. High SSRI users gained 0.48 (95% CI 0.20 to 0.76) kg more than non-users. There was no association between tricyclic or other antidepressant use and weight gain. The association between SSRI use and weight gain was stronger among those with high intake of Western diet, greater sedentary activity, and who smoked.
SSRIs use was associated with weight gain in the presence of unhealthy behaviours including Western diet, sedentarism and smoking.
研究抗抑郁药的使用与体重增加之间的关联,以及与生活方式因素的相互作用。
纵向研究。
我们使用了来自西北阿德莱德健康研究两个阶段(相隔4.4年)的2334名成年人的数据,包括经过验证的饮食和生活方式问卷、测量的体重以及相关的药物处方数据。
体重变化。
188名(8.1%)参与者平均每年有1 - 2张抗抑郁药处方,212名(9.1%)参与者每年有超过两张处方。非使用者、低剂量(每年1 - 2张处方)和高剂量(每年>2张处方)抗抑郁药使用者的平均年体重增加分别为0.12、0.18和0.28千克。在多变量回归模型中,抗抑郁药的使用与体重增加呈正相关:高剂量抗抑郁药使用者每年额外增加0.22(95%置信区间0.00至0.44)千克。这种关联主要归因于选择性5-羟色胺再摄取抑制剂(SSRI)的使用。高剂量SSRI使用者比非使用者多增重0.48(95%置信区间0.20至0.76)千克。三环类或其他抗抑郁药的使用与体重增加之间没有关联。在西方饮食摄入量高、久坐不动以及吸烟的人群中,SSRI使用与体重增加之间的关联更强。
在存在西方饮食、久坐不动和吸烟等不健康行为的情况下,使用SSRI与体重增加有关。