Izsak Julia, Kimland Elin E, Martikainen Jari, Dahlén Elin, Kindblom Jenny M
Department of Drug Treatment, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Int J Obes (Lond). 2025 Mar;49(3):527-531. doi: 10.1038/s41366-024-01677-2. Epub 2024 Nov 14.
Overweight and obesity in children and adolescents may impact pharmacokinetics and drug exposure. The aim of the present study was to evaluate doses of antidepressants in relation to body weight in children. We used data from the BMI Epidemiology Study (BEST) Gothenburg cohort and the National Prescribed Drug Register and included children and adolescents with a prescription of fluoxetine (n = 347) or sertraline (n = 733) and a weight measurement. For fluoxetine, individuals with overweight or obesity received slightly lower doses at first prescriptions, but not in iterated prescriptions. The weight-normalized dose was lower in individuals with overweight or obesity in first and iterated prescriptions, compared with normal weight (p < 0.01). For sertraline, there were no significant dose differences between individuals with overweight or obesity, compared with normal weight. However, pronounced differences were seen in dose per kilogram body weight in both first and iterated prescriptions (p < 0.01). We conclude that the doses of fluoxetine and sertraline were essentially similar in individuals with overweight or obesity, but the weight-normalized doses were clearly lower. Given the ongoing obesity epidemic, larger studies addressing optimal dosing in individuals with elevated weight are warranted.
儿童和青少年的超重与肥胖可能会影响药物代谢动力学和药物暴露情况。本研究的目的是评估儿童抗抑郁药剂量与体重之间的关系。我们使用了哥德堡队列的BMI流行病学研究（BEST）和国家处方药登记处的数据，纳入了有氟西汀（n = 347）或舍曲林（n = 733）处方且有体重测量数据的儿童和青少年。对于氟西汀，超重或肥胖个体在首次处方时接受的剂量略低，但在重复处方时并非如此。与正常体重个体相比，超重或肥胖个体在首次和重复处方时的体重标准化剂量较低（p < 0.01）。对于舍曲林，超重或肥胖个体与正常体重个体之间的剂量没有显著差异。然而，在首次和重复处方中，每千克体重的剂量均存在明显差异（p < 0.01）。我们得出结论，超重或肥胖个体中氟西汀和舍曲林的剂量基本相似，但体重标准化剂量明显较低。鉴于当前肥胖流行的情况，有必要开展更大规模的研究来探讨体重增加个体的最佳给药剂量。
