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To discern changes in body mass index (BMI) in patients on long-term antidepressant treatment in a general practice population and establish BMI changes in patients with and without a diagnosis of diabetes. We used a retrospective observational method and identified patients on four antidepressants of interest. We excluded those who did not have start and current BMI readings within the past 3 years and noted whether or not patients had a diagnosis of diabetes.
Long-term treatment with citalopram, fluoxetine, mirtazapine and sertraline was associated with increased BMI in two-thirds of patients. There was reduction in BMI in patients with diabetes and an increase in BMI for patients who did not have diabetes.
Awareness of environmental factors and their impact on individuals is important. Medication is not the only cause of abnormal metabolic effects. Overall monitoring of physical health is important in all groups of patients.
Using a retrospective observational approach, we aimed to discern whether there was a difference in metabolic parameters between psychiatric and general practice populations in the same locality. Second, we aimed to establish differences in metabolic parameters of patients taking olanzapine, clozapine or aripiprazole.
Patients with psychiatric illness had a body mass index (BMI) comparable to that of the general practice population (28.7 v. 29.7 kg/m2), but blood glucose was significantly lower in the general practice population (4.8 v. 6.1 mmol/L). Olanzapine was associated with the lowest BMI (26.1 kg/m2) and aripiprazole the highest (32.2 kg/m2), with no difference in blood glucose between antipsychotics.
Awareness of environmental factors and how they affect individuals is important and medications are not the only cause of metabolic effects. There may be a channelling bias present, meaning practitioners are cognisant of potential metabolic effects prior to prescribing. Overall monitoring of physical health is important regardless of potential cause.