Calarge Chadi, Amushie Chima, Dinh Stephanie, Mills James A, Devaraj Sridevi, Barba-Villalobos Griselda, Nguyen Jacqueline, Garcia Jose M, Sisley Stephanie, Bacha Fida, Zemel Babette
Department of Management, Policy, and Community Health, University of Texas Health Science Center at Houston, Houston, TX.
From the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine.
J Clin Psychopharmacol. 2024 Nov-Dec;44(6):538-544. doi: 10.1097/JCP.0000000000001922. Epub 2024 Oct 14.
The aim of this study was to examine the effect of fluoxetine and sertraline on height growth and insulin-like growth factor-1 (IGF-1) during puberty.
In this 6-month cohort study, electronic medical records were used to identify 8- to 15-year-old participants, within 1 month of starting fluoxetine (n = 39) or sertraline (n = 27), and sexual maturation stages 2 to 4 were confirmed. Conditions that interfere with height growth led to exclusion. Participants underwent anthropometric assessments and phlebotomy. Healthy, unmedicated children (n = 36) also provided anthropometric data.
After the baseline height Z-score, sex, Tanner stage, daily selective serotonin reuptake inhibitor (SSRI) dose, and time were accounted for, the interaction effect of dose by time was inversely associated with height Z-score in SSRI-treated participants (β = -0.18; 95% confidence interval [CI]: -0.35, -0.02). Sertraline and fluoxetine did not differ in their effect on height growth. Compared with being unmedicated, SSRI treatment was associated with a smaller growth in height (time × dose 2-way interaction effect β = -1.30; 95% CI: -2.52, -0.09). The interaction effect of dose by time was significant for body mass index Z-score (β = 0.35; 95% CI: 0.06, 0.64) but not weight Z-score (β = 0.24; 95% CI: -0.01, 0.49). Body mass index Z-score increased more with sertraline compared with fluoxetine (time × dose × SSRI type 3-way interaction effect P < 0.05). SSRI dose was inversely associated with IGF-1 (β = -63.5; 95% CI: -112.2, -14.7) but not insulin growth factor binding protein-3 concentration (β = -207.3; 95% CI: -536.2, 121.5).
Fluoxetine and sertraline reduce height gain and IGF-1 concentration, in a dose-dependent manner. Longer-term studies are necessary.
本研究旨在探讨氟西汀和舍曲林对青春期身高增长及胰岛素样生长因子-1（IGF-1）的影响。
在这项为期6个月的队列研究中，利用电子病历确定8至15岁的参与者，这些参与者在开始服用氟西汀（n = 39）或舍曲林（n = 27）后1个月内，且性成熟阶段为2至4期，排除干扰身高增长的情况。参与者接受人体测量评估和静脉采血。健康、未用药的儿童（n = 36）也提供了人体测量数据。
在考虑基线身高Z评分、性别、坦纳分期、每日选择性5-羟色胺再摄取抑制剂（SSRI）剂量和时间后，在接受SSRI治疗的参与者中，剂量与时间的交互作用与身高Z评分呈负相关（β = -0.18；95%置信区间[CI]：-0.35，-0.02）。舍曲林和氟西汀对身高增长的影响无差异。与未用药相比，SSRI治疗与身高增长较小有关（时间×剂量双向交互作用效应β = -1.30；95%CI：-2.52，-0.09）。剂量与时间的交互作用对体重指数Z评分有显著意义（β = 0.35；95%CI：0.06，0.64），但对体重Z评分无显著意义（β = 0.24；95%CI：-0.01，0.49）。与氟西汀相比，舍曲林使体重指数Z评分增加更多（时间×剂量×SSRI类型三向交互作用效应P < 0.05）。SSRI剂量与IGF-1呈负相关（β = -63.5；95%CI：-112.2，-14.7），但与胰岛素生长因子结合蛋白-3浓度无相关性（β = -207.3；95%CI：-536.2，121.5）。
氟西汀和舍曲林以剂量依赖的方式降低身高增长和IGF-1浓度。有必要进行长期研究。
