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Gafoor, 2018 Antidepressant utilisation and incidence of weight gain during 10 years’ follow-up: population based cohort study


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BMJ 2018361 doi: https://doi.org/10.1136/bmj.k1951 (Published 23 May 2018)

Antidepressant utilisation and incidence of weight gain during 10 years’ follow-up: population based cohort study

Rafael Gafoor, research associate, Helen P Booth, senior researcher, Martin C Gulliford, professor of public health

 

Full text - https://www.bmj.com/content/361/bmj.k1951


Objective: 

To evaluate the long term association between antidepressant prescribing and body weight.

 

Design:

Population based cohort study.

 

Setting:

General practices contributing to the UK Clinical Practice Research Datalink, 2004-14.

 

Participants:

136 762 men and 157 957 women with three or more records for body mass index (BMI).

 

Main outcome measures:

The main outcomes were antidepressant prescribing, incidence of ≥5% increase in body weight, and transition to overweight or obesity. Adjusted rate ratios were estimated from a Poisson model adjusting for age, sex, depression recording, comorbidity, coprescribing of antiepileptics or antipsychotics, deprivation, smoking, and advice on diet.

 

Results:

In the year of study entry, 17 803 (13.0%) men and 35 307 (22.4%) women with a mean age of 51.5 years (SD 16.6 years) were prescribed antidepressants. During 1 836 452 person years of follow-up, the incidence of new episodes of ≥5 weight gain in participants not prescribed antidepressants was 8.1 per 100 person years and in participants prescribed antidepressants was 11.2 per 100 person years (adjusted rate ratio 1.21, 95% confidence interval 1.19 to 1.22, P<0.001). The risk of weight gain remained increased during at least six years of follow-up. In the second year of treatment the number of participants treated with antidepressants for one year for one additional episode of ≥5% weight gain was 27 (95% confidence interval 25 to 29). In people who were initially of normal weight, the adjusted rate ratio for transition to overweight or obesity was 1.29 (1.25 to 1.34); in people who were initially overweight, the adjusted rate ratio for transition to obesity was 1.29 (1.25 to 1.33). Associations may not be causal, and residual confounding might contribute to overestimation of associations.

 

Conclusion:

Widespread utilisation of antidepressants may be contributing to long term increased risk of weight gain at population level. The potential for weight gain should be considered when antidepressant treatment is indicated.

2001: 20mg paroxetine
2003-2014: Switched between 20mg citalopram and 10mg escitalopram with several failed CT's
2015: Jan/ Feb-very fast taper off citalopram; Mar/ Apr-crashed; 23 Apr-reinstated 5mg; 05 May-updosed to 10mg; 15 Jul-started taper; Aug-9.0mg; Sep-8.1mg; Oct-7.6mg; Nov-6.8mg; Dec-6.2mg
2016: Jan-5.7mg; Feb-5.2mg; Mar-5.0mg;  Apr-4.5mg; May-4.05mg; Jun-3.65mg; Jul-3.3mg; Aug-2.95mg; 04Sep-2.65mg; 25Sep-2.4mg; 23Oct-2.15mg; 13Nov-1.95mg; 04Dec-1.75mg; 25Dec-1.55mg.
2017: 08Jan-1.4mg; 22Jan-1.25mg; 12Feb-1.1mg; 26Feb-1.0mg; 05Mar-0.9mg; 15Mar-0.8mg; 22Mar-0.7mg; 02Apr-0.6; 09Apr-0.5mg; 16Apr-0.4mg; 23Apr-0.3; 03May-0.2mg; 10May-0.1mg

Finished taper 17 May 2017.

 

I am not a medical professional. The information I provide is not medical advice. If in doubt please consult with a qualified healthcare provider.

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Good find @Dan998

 

I saw something the other day that said - with no irony - that SSRIs don't make you gain weight, they just increase your appetite. (IIRC it was a university lecture on psychopharmacology - a lot of this sort of thing is recorded at the college and uploaded to youtube for students to see.)

2005 St John's Wort / 2006-2012 Lexapro 20mg, 2 failed attempts to stop, tapered over 4.5 months in early 2012

January 2013 started Sertraline, over time worked up to 100mg

July 2014 Sertraline dropped from 100mg to 75mg, held for six months, slower tapering until 2019 22 Dec 3.2mg

2020 Sertraline 19 Jan 3.1mg, 26 Jan 3.0mg; 1 Mar 2.9, 7 Mar 2.8, May (some drops here) 24 May 2.5, May 29 2.4, June 21 2.3, June 28 2.2mg,  July 4 2.1mg, July 24 (or maybe a bit before) 2mg, early Nov switched to home made suspension; 29 Nov 1.8mg; approx 25 Dec 1.6mg)

2021 Some time in about Jan/Feb realised my dosing was off and as probably on more like 1.8mg and possible mixing error in making suspension; doses after 10 Feb accurate; 10 Feb 1.6mg; 7 Mar 1.4

 

My thread here at SA: https://www.survivingantidepressants.org/topic/1775-bubbles/page/17/

CurrentSertraline: 7 Mar 1.4mg / Armour Thyroid / endless allergy meds, erg

 

 

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