Extended SSRI treatment associated with risk of weight gain

WESTPORT  - Different selective serotonin reuptake inhibitors (SSRIs) are associated with different risks for weight gain in patients being treated for extended periods of time.

Dr. Maurizio Fava, of Massachusetts General Hospital in Boston, and colleagues compared the mean percent change in weight, The study included two blinded 4- to 6-day treatment interruptions between weeks 14 and 28 in order to assess the effects of SSRI treatment interruption, according to the report. Forty-four patients taking fluoxetine, 48 taking sertraline, and 47 taking paroxetine completed the trial and were included in the analyses.

"Striking differences emerged when comparing mean percent change in weight from baseline to endpoint for the three SSRIs," the investigators say. They observed a small mean decrease in weight (-0.2%) in the fluoxetine group and a small mean increase in weight (1.0%) in the sertraline group, neither of which was statistically significant. In contrast, the paroxetine group showed a significant increase in weight, at 3.6%.

According to the report, the number of patients whose weight increased at least 7% from baseline was significantly greater for the paroxetine group (25.5%) compared with either the fluoxetine group (6.8%) or the sertraline group (4.2%). "After 26 to 32 weeks of therapy, the maximum weight gain for any patient was 7.7 kg for fluoxetine, 8.6 kg for sertraline, and 14.1 kg for paroxetine."

"The clinical relevance of this finding is heightened in the context of treatment of depressed patients in whom added weight could pose serious health risks or for whom noncompliance with a treatment regimen could be hazardous".