Body weight as a predictor of antidepressant efficacy in the GENDEP project.

Abstract

BACKGROUND:

Being overweight or obese may be associated with poor response to antidepressants. The present report explores the moderation of antidepressant response by body weight to establish the specificity to antidepressant mode of action, type of depressive symptoms and gender.

METHODS:

Height and weight were measured in 797 men and women with major depression treated with escitalopram or nortriptyline for twelve weeks as part of the Genome Based Therapeutic Drugs for Depression (GENDEP) project. Body mass index (BMI) and obesity (BMI>30) were tested as predictors of change in depressive symptoms using mixed linear models.

RESULTS:

Higher BMI and obesity predicted poor response to nortriptyline but did not significantly influence response to escitalopram. The moderation of response by body weight was due to differential improvement in neurovegetative symptoms, including sleep and appetite. The relationship between body weight and change in neurovegetative symptoms was moderated by gender with obese men responding less to nortriptyline and obese women having poorer response to both antidepressants.

LIMITATIONS:

As no placebo arm was included, the specificity of findings to antidepressants is relative. Lack of specific measures precluded accounting for differences in body fat distribution.

CONCLUSIONS:

Body weight should be considered in the assessment of depression as it may inform the selection of antidepressant treatment.

• Authors: Rudolf Uher, Ole Mors, Joanna Hauser, Marcella Rietschel, Wolfgang Maier, Dejan Kozel, Neven Henigsberg, Daniel Souery, Anna Placentino, Nader Perroud, Moica Zvezdana Dernovsek, Jana Strohmaier, Erik Roj Larsen, Astrid Zobel, Anna Leszczynska-Rodziewicz, Petra Kalember, Laura Pedrini, Sylvie Linotte, Cerisse Gunasinghe, Katherine J Aitchison, Peter McGuffin, Anne Farmer
• Journal: Journal of affective disorders (J Affect Disord) Vol. 118 Issue 1-3 Pg. 147-54 (Nov 2009) ISSN: 1573-2517 [Electronic] Netherlands
• PMID: 19269691 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Antidepressive Agents, Second-Generation
• Antidepressive Agents, Tricyclic
• Citalopram
• Nortriptyline

Topics

• Adult
• Affect (drug effects)
• Antidepressive Agents, Second-Generation (adverse effects, pharmacokinetics, therapeutic use)
• Antidepressive Agents, Tricyclic (adverse effects, pharmacokinetics, therapeutic use)
• Appetite (drug effects)
• Body Mass Index
• Body Weight (physiology)
• Citalopram (adverse effects, pharmacokinetics, therapeutic use)
• Depressive Disorder, Major (drug therapy, genetics, physiopathology)
• Female
• Humans
• Male
• Middle Aged
• Nortriptyline (adverse effects, pharmacokinetics, therapeutic use)
• Obesity (physiopathology, psychology)
• Overweight (physiopathology, psychology)
• Sleep (drug effects)
• Treatment Outcome