Citation: Translational Psychiatry (2016) 6, e759; doi:10.1038/tp.2016.25
Published online 15 March 2016
In United States of America, over the past two decades, the rate of antidepressant use has increased nearly 400%, where antidepressant drugs were the third most prescribed class of drugs for persons aged 18-44 years in 2005–2008.25 In 2010, it was reported that 52.3 daily doses were prescribed for every 1000 inhabitants in European countries.26 In Australia, 34 million prescriptions were issued for mental health-related diseases in 2013–2014, and 67% (23 million) of those were for antidepressants.27 In 2012–2013, mental health-related prescriptions cost the Australian Government over $788 million.27 With a rapid rise of individuals taking antidepressants, numerous studies have investigated the effects of different classes of antidepressants on body weight. Despite the concomitant occurrence of the frequent use of antidepressants and the high incidence of obesity in Western societies, the pathways and mechanisms by which antidepressants can induced weight gain remain unclear.
In this review, we examine the pathophysiology of MDD and obesity, and their complex interactions. More specifically, we discuss the role of antidepressant use in weight gain, and the role of interactions with environmental factors, such as stress.
In addition to the clinical studies described above, case studies have reported extreme weight gain in patients with SSRI treatment.97, 98 In the study conducted by Bouwer et al., treatment with citalopram led to weight gain and carbohydrate craving in eight out of eighteen patients. In a 4-week period, one female patient gained 8 kg, whereas in a 5-week period one male patient gained 9 kg.98 In another case study, a 33-year-old schizophrenic female patient was treated with fluoxetine (40 mg per day) for a 9-month period following antipsychotic treatment with risperidone (6 mg per day) and clorazepate (15 mg per day).97 The patient was discontinued from fluoxetine because she underwent excessive weight gain (52 kg) accompanied with carbohydrate craving.97Therefore, some individuals may be more sensitive to weight gain induced by SSRIs than others.97, 98