Obesity, Dyslipidemia, and Diabetes With Selective Serotonin Reuptake Inhibitors: The Hordaland Health Study
J Clin Psychiatry 2006;67(12):1974-1982
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: This study aimed to
examine whether subjects taking selective serotonin
reuptake inhibitors (SSRIs) are more likely to
have elements of the metabolic syndrome compared with those taking no psychotropic drugs.
For comparison, we also studied subjects taking
Method: We used data from The
Hordaland Health Study '97-'99, a general community
cross-sectional health survey including 25,315
subjects aged 40 to 49 and 70 to 74 years. For the
groups studied, we estimated prevalence and odds
ratios (ORs) for obesity, hypercholesterolemia,
low high-density lipoprotein cholesterol, hypertriglyceridemia, and diabetes.
Results: We observed an association
between use of SSRIs as a group (N = 461) and
abdominal obesity (OR = 1.40, 95% CI = 1.08 to 1.81)
and hypercholesterolemia (OR = 1.36, 95% CI = 1.07 to 1.73) after adjusting for multiple possible
confounders. There was also a trend toward an association between SSRI use and diabetes. In a
subgroup analysis of subjects taking SSRIs, the
use of paroxetine (N = 187) was markedly
associated with both general and abdominal obesity but
not with hypercholesterolemia. In contrast, the use
of citalopram (N = 142) was not associated with
any of the metabolic outcome variables, while the
use of any other SSRI (sertraline, fluoxetine, or
fluvoxamine) (N = 131) as a mixed subgroup was associated with both abdominal obesity and
hypercholesterolemia. We also replicated the previously reported associations between use of
antipsychotics and obesity and metabolic disturbances.
Conclusion: We have shown that use of
at least some SSRIs is associated with clinical
and biochemical elements of the metabolic
syndrome. Our data indicate differences in the
metabolic side effect profile among various SSRI
drugs, although treatment bias might have
influenced these results. We suggest that patients
taking SSRIs be carefully monitored for obesity and