Common Medications Which Lead to Unintended Alterations in Weight Gain or Organ Lipotoxicity

Abstract

Obesity is one of the most common chronic conditions in the world. Its management is difficult, partly due to the multiple associated comorbidities including fatty liver, diabetes, hypertension, and hyperlipidemia. As a result, the choice of prescription medications in overweight and obese patients has important implications as some of them can actually worsen the fat accumulation and its associated metabolic complications. Several prescription medications are associated with weight gain with mechanisms that are often poorly understood and under-recognized. Even less data are available on the distribution of fat and lipotoxicity (the organ damage related to fat accumulation). The present review will discuss the drugs associated with weight gain, their mechanism of action, and the magnitude and timing of their effect.

Serotonin Transporter Deficiency is Associated with Dysbiosis and Changes in Metabolic Function of the Mouse Intestinal Microbiome

“…Selective serotonin reuptake inhibitors (SSRIs) are pharmacological agents which inhibit SERT function that are used to treat depression and other psychiatric disorders. In accordance with the metabolic phenotype in SERT −/− mice, patients taking SSRIs exhibit weight gain and an increased risk of developing T2D 23 . Therefore, it is critical to enhance our understanding of how decreased SERT function is linked to metabolic disorders.…”

Review article: drug‐induced liver injury in the context of nonalcoholic fatty liver disease – a physiopathological and clinical integrated view

“…Hydrochlorothiazide, a thiazide diuretic lacking hepatotoxicity potential, is another example. It has diabetogenic potential when administered to obese but not to lean individuals by aggravating IR, thus exacerbating liver fat accumulation and visceral fat redistribution; these effects have been suggested to be dose‐dependent in nature …”

Doxepin Exacerbates Renal Damage, Glucose Intolerance, Nonalcoholic Fatty Liver Disease, and Urinary Chromium Loss in Obese Mice

“…However, in patients using antipsychotics, doxepin can lead to hyperglycemia and exacerbate preexisting diabetes, hypertriglyceridemia, and hypercholesterolemia [30][31][32], but it can be an effective treatment option for postprandial hypoglycemia [33]. Long-term doxepin use can also induce NAFLD-associated body weight gain [34] and liver injury [35]. Antipsychotics, including doxepin, aripiprazole, fluphenazine, risperidone, nitrazepam, olanzapine, and ziprasidone, may cause medication-associated nephrotoxicity; thus, concerns regarding whether these drugs may increase the risk of kidney injury (e.g., interstitial nephritis, glomerulonephritis, and CKD) have been raised [8,36].…”