Psychotropic Drug Considerations in Depressed Patients with Metabolic Disturbances

Vieweg, W. Victor R.; Levy, James R.; Fredrickson, Sonja K.; Chipkin, Stuart R.; Beatty-Brooks, Mary; Fernandez, Antony; Hasnain, Mehrul; Pandurangi, Anand K.

doi:10.1016/j.amjmed.2007.08.043

Cited by 22 publications

(21 citation statements)

References 78 publications

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“…However in our study we found evidence for an association between mental disorders and weight gain independent of smoking, alcohol consumption, physical activity and social activity, which was in line with recent prospective studies that adjusted for lifestyle (Brumpton et al, 2013;Singh et al, 2014;Lasserre et al, 2014). The use of psychotropic medication has been suggested as a confounding factor in the association between psychopathology and weight change since medication use has shown to interact with mechanisms regulating food intake and appetite (Virk et al, 2004;Demyttenaere and Jaspers, 2008;Papakostas, 2008;Vieweg et al, 2008;Hasnain and Vieweg, 2013). Initially we found in a subsample of our study with persons having a current depressive and anxiety disorders that SSRI users as well as benzodiazepine users compared to non-users were more likely to gain weight.…”

Section: Discussionsupporting

confidence: 77%

“…However, the found effects for SSRI use seemed to be mainly driven by the severity of the depressive symptoms. Surprisingly, the effect of benzodiazepine use on weight gain remained borderline significant after full adjustment, which is conflicting with previous research which found that benzodiazepine use was weight neutral (Vieweg et al, 2008;Hasnain and Vieweg, 2013). Other explaining mechanisms for the association between mental disorders and subsequent weight increase are physiological abnormalities found in depressed persons such as increased inflammation, and longterm disturbances of the HPA-axis.…”

Section: Discussioncontrasting

confidence: 55%

“…Some recent cross-sectional and longitudinal studies suggest that depressive and anxiety symptoms are associated with weight independently from lifestyle factors (physical activity, smoking and alcohol consumption) suggesting that there is no or a limited influence of lifestyle factors (Zhao et al, 2009). Furthermore the use of psychotropic medications, often prescribed for depressive and anxiety disorders, might be an additional explanatory risk factor for weight change (Virk et al, 2004;Demyttenaere and Jaspers, 2008;Vieweg et al, 2008;Hasnain and Vieweg, 2013). Underlying shared biological abnormalities such as inflammation, leptin or HPA-axis dysregulations could further play a linking role between mental health and weight change (Bjorntorp, 2001;Bornstein et al, 2006;Pasco et al, 2008;Vreeburg et al, 2009;Milaneschi et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Depressive and anxiety disorders: Associated with losing or gaining weight over 2 years?

Wit

Straten

Lamers

et al. 2015

Psychiatry Research

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a b s t r a c tThis longitudinal study examines to what extent different depressive and anxiety disorders and clinical characteristics are associated with subsequent weight change, while controlling for baseline weight, sociodemographics, health status, psychotropic medication use and (un)healthy lifestyle factors. Data are from a sample of 2447 respondents aged 18-65 years of the Netherlands Study of Depression and Anxiety (NESDA). Baseline depressive disorders and anxiety disorders were determined with the Composite International Diagnostic Interview (CIDI). Weight at baseline and after 2 years was measured and analyzed as continuous change score (mean change in weight 1 kg) and in categories of significant weight loss ( o1 S.D. weight change equaling o 4 kg), weight maintenance and weight gain ( 41 S.D., 46 kg). After full adjustment for covariates baseline comorbid anxiety and depressive disorder and baseline Major Depressive Disorder (MDD) were associated with significant 2-year weight gain. Both current and remitted MDD at baseline and a baseline dysthymia, but none of the anxiety disorders, were associated with significant weight loss. This longitudinal study confirms a U-curved link between depression and weight change over 2 years. Furthermore, a dose-response effect of depression severity on 2-year weight gain was found.

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Section: Discussionsupporting

confidence: 77%

Section: Discussioncontrasting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

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Depressive and anxiety disorders: Associated with losing or gaining weight over 2 years?

Wit

Straten

Lamers

et al. 2015

Psychiatry Research

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“…Body weight gain is generally considered to be more frequent in patients treated with tricyclic antidepressants than with selective serotonin reuptake inhibitors (Zimmermann et al, 2003;Vieweg et al, 2008). MAO inhibitors, including phenelzine, are also rather associated with weight gain to an extent comparable with tricyclic antidepressants even if the contribution of increased adiposity remains unknown (Remick et al, 1989;Balon et al, 1993).…”

Section: Antidepressant Impact On Adipogenesis In Vitro 1059mentioning

confidence: 99%

Antidepressant Phenelzine Alters Differentiation of Cultured Human and Mouse Preadipocytes

F¹,

Guillou²,

Chétrite³

et al. 2009

Mol Pharmacol

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Change in body weight is a frequent side effect of antidepressants and is considered to be mediated by central effects on food intake and energy expenditure. The antidepressant phenelzine (Nardil) potently inhibits both monoamine oxidase and semicarbazide-sensitive amine oxidase activities, two enzymes that are highly expressed in adipose tissue, raising the possibility that it could directly alter adipocyte biology. Treatment with this compound is rather associated with weight gain. The aim of this work was to examine the effects of phenelzine on differentiation and metabolism of cultured human and mouse preadipocytes and to characterize the mechanisms involved in these effects. In all preadipocyte models, phenelzine induced a time-and dosedependent reduction in differentiation and triglyceride accumulation. Modulation of lipolysis or glucose transport was not involved in phenelzine action. This effect was supported by the reduced expression in the key adipogenic transcription factors peroxisome proliferator-activated receptor-␥ (PPAR-␥) and CCAAT/enhancer binding protein-␣, which was observed only at the highest drug concentrations (30 -100 M). The PPAR-␥ agonists thiazolidinediones did not reverse phenelzine effects. By contrast, the reduction in both cell triglycerides and sterol regulatory element-binding protein-1c (SREBP-1c) was detectable at lower phenelzine concentrations (1-10 M). Phenelzine effect on triglyceride content was prevented by providing free fatty acids to the cells and was partially reversed by overexpression of a dominant-positive form of SREBP-1c, showing the privileged targeting of the lipogenic pathway. When considered together, these findings demonstrate that an antidepressant directly and potently inhibits adipocyte lipid storage and differentiation, which could contribute to psychotropic drug side effects on energy homeostasis.

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“…verse effect of psychotropics on appetite, eating behaviour, body weight and metabolism [18] , should improve our ability to prevent and treat both obesity and depression. Thereby, ideally persontailored interventions can be developed, including effective nonpharmaceutical preventive strategies for recurrent depression [9,[19][20][21] and extra physical activities with -as added benefit -protection against AD-induced weight gain.…”

mentioning

confidence: 99%

The ‘Weight’ of Recurrent Depression: A Comparison between Individuals with Recurrent Depression and the General Population and the Influence of Antidepressants

Lok

Visscher

Koeter

et al. 2010

Psychother Psychosom

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Psychotropic Drug Considerations in Depressed Patients with Metabolic Disturbances

Cited by 22 publications

References 78 publications

Depressive and anxiety disorders: Associated with losing or gaining weight over 2 years?

Depressive and anxiety disorders: Associated with losing or gaining weight over 2 years?

Antidepressant Phenelzine Alters Differentiation of Cultured Human and Mouse Preadipocytes

The ‘Weight’ of Recurrent Depression: A Comparison between Individuals with Recurrent Depression and the General Population and the Influence of Antidepressants

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