Psychotropic Medications Linked to Increased Rates of Obesity

Crina Frincu-Mallos, PhD

March 08, 2010

March 8, 2010 (Baltimore, Maryland) — Psychotropic medications, specifically antidepressants and antipsychotics, are associated with higher rates of obesity, new national data suggest.

The research, presented here at the Anxiety Disorders Association of America 30th Annual Conference, shows that the obesity rate among individuals taking antidepressants during the past 12 months was 1.5 times greater compared with individuals not taking these medications. In addition, the obesity rate among subjects taking antipsychotics was more than double.

A collaboration between researchers from the United States and Canada, the study examined the relationship between obesity and specific classes of psychotropic medications, including antidepressants, antipsychotics, anxiolytics, hypnotics, and mood stabilizers, in a large, nationally representative sample of 36,984 participants.

Study subjects were participants in the Canadian Community Health Survey Mental Health and Well-being.

"There are issues that haven’t really been addressed in a population that already is at risk for unhealthy behaviors, since the risk for obesity is added on top of their mental illness," said first author Candyce D. Tart, MA, doctoral candidate in the Psychology Department at Southern Methodist University, Dallas, Texas.

The preliminary results of the study, with principal investigator Jasper Smits, associate professor and director of the Anxiety Research & Treatment Program at Southern Methodist University, Dallas, Texas, suggest that the increased odds of obesity in mood disorders and anxiety disorders is mediated by psychotropic medication use.

More precisely, the effects of psychotropic medication use appear to be specific to antidepressants and antipsychotics. The investigators found no relationship between mood stabilizers and obesity — a finding that contradicts previous research showing that these drugs are associated with significant weight gain.

Exercise, Nutrition Advice: A Valuable Addition

"If we are going to prescribe medications, we need to assist with addressing the possible risk of increased obesity and counsel them accordingly about weight management,” Ms. Tart told Medscape Psychiatry.

She added that physicians could also help such patients by providing them with nutritional and physical activity counseling.

Physical activity interacts positively with medication on a biological level by improving serotonin levels, added Ms. Tart. She added that although psychotropic medications are "miracle drugs" for many patients, the weight gain properties of these agents can also contribute to depression.

Discussing the potential weaknesses of the study, Ms. Tart noted that this is a cross-sectional study. Also, she acknowledged that, as with “all psychological processes, there is likely bidirectional meaning: if you are obese, with the stigma associated with it, the lack of energy, the physical pain, and problems that come with it may make you more depressed.”

Ms. Tart added that this research should be followed by longitudinal studies in which the relationships among diagnosis, medication use, and weight are followed over time. This would help better understand how much mood and medication affect weight and vice versa.

Important Reminder

"Several psychotropics are associated with weight gain as a risk factor: we still have to look at whether that is an outcome or an association," said Jerrold F. Rosenbaum, MD, psychiatrist-in-chief at Massachusetts General Hospital and Stanley Cobb Professor of Psychiatry at Harvard Medical School in Boston, Massachusetts. Dr. Rosenbaum, who is not associated with the study, commented on these findings in an interview with Medscape Psychiatry.

"Are people with obesity and psychiatric symptoms more likely to get treated, for example? The fact is, we know that with many psychotropic drugs you have to be aware of the risk-benefit ratio and monitor weight gain," he added. "There are choices one can make among the class of psychotropics, drugs that are greater or lesser offenders as far as weight gain.”

"The study is an important reminder that there are health consequences in drug choice and those have to be weighed against symptom control and treatment," said Dr. Rosenbaum.

Ms.Tart and Dr. Rosenbaum have disclosed no relevant financial relationships.

Anxiety Disorders Association of America (ADAA) 30th Annual Conference: Abstract 149. Presented March 5, 2010.


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