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Underweight Patients Benefit Most From Antidepressants, Study Finds
Patients with major depressive disorder who are underweight glean the most benefit from antidepressant treatment, researchers reported in a study published online in the Journal of Affective Disorders.
“We confirmed,” they wrote, “that body mass index (BMI) can predict treatment outcomes in major depressive disorder.”
The finding stemmed from a post hoc analysis of data from a clinical trial that included 202 adults with major depressive disorder who took paroxetine, mirtazapine, or paroxetine plus mirtazapine. Researchers were interested in associations of BMI with treatment outcomes.
At baseline, 55% of patients were normal weight, 9.9% were underweight, and 35.1% were overweight. After 8 weeks of antidepressant treatment, patients who were underweight showed the greatest improvement, researchers reported.
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Patients with an underweight or normal BMI were twice as likely to experience remission of depression, compared with patients who were overweight, the study found. As BMI increased, the reduction in the total score on the 17-item Hamilton Rating Scale for Depression decreased.
Researchers hypothesized antidepressants may be less effective in patients with higher BMI due to the drug having to travel through more tissue and fluid, according to Psychiatric News Alert coverage of the study.
“The other potential mechanisms underlying the association between body weight and antidepressant response could be attributed to brain insulin resistance, inflammatory dysregulation, oxidative and nitrosative stress which is caused by obesity,” the report quoted from the study. “Finally, decreased physical activity and obesity stigma can also contribute to poor response to antidepressants in patients with excess weight.”
—Jolynn Tumolo
References
Patient’s weight may affect response to antidepressants. Psychiatric News Alert. November 13, 2020.
