gms | German Medical Science

56. Kongress für Allgemeinmedizin und Familienmedizin

Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin (DEGAM)

15. - 17.09.2022, Greifswald

Prescribing antidepressants in general practice: can obesogenic adverse effects be associated with worse health outcomes in patients with depression and excess weight?

Meeting Abstract

  • presenting/speaker Svetlana Puzhko - McGill University, Family Medicine, Kanada
  • Tibor Schuster - McGill University, Family Medicine, Kanada
  • Christel Renoux - McGill University, Department of Neurology & Neurosurgery, Kanada; McGill University, Department of Epidemiology and Biostatistics, Kanada; Lady Davis Institute for Medical Research, Centre for Clinical Epidemiology, Kanada
  • Tracie A. Barnett - McGill University, Family Medicine, Kanada
  • Kimberly Munro - McGill University, Family Medicine, Kanada
  • Gillian Bartlett - McGill University, Family Medicine, Kanada; University of Missouri, School of Medicine, USA

Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin. 56. Kongress für Allgemeinmedizin und Familienmedizin. Greifswald, 15.-17.09.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocSYM-04-04

doi: 10.3205/22degam263, urn:nbn:de:0183-22degam2632

Published: September 15, 2022

© 2022 Puzhko et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Hintergrund: The majority of antidepressants (AD) are prescribed by general practitioners. Patients with excess weight may have a poor response to AD and may be more vulnerable to negative consequences of weight-increasing (obesogenic) adverse effects. It is important to evaluate the need to implement a differential approach to AD selection for patients with excess weight.

Fragestellung: To estimate the difference in risk for all-cause hospitalizations between people with and without excess weight who were prescribed obesogenic AD.

Fragestellung/Diskussionspunkt: The cohort of incident users of AD, with depression diagnosed and weight status measured before the first AD prescription, was extracted from the population-based cohort “TorSaDE” (Quebec, Canada). The role of excess weight in the association between exposure to obesogenic AD and all-cause hospitalizations during the 12 months of treatment was examined. Cox regression analysis, with a time-varying exposure to obesogenic AD (versus non-obesogenic AD) and time-fixed weight status was applied.

Methoden: The cohort of incident users of AD, with depression diagnosed and weight status measured before the first AD prescription, was extracted from the population-based cohort “TorSaDE” (Quebec, Canada). The role of excess weight in the association between exposure to obesogenic AD and all-cause hospitalizations during the 12 months of treatment was examined. Cox regression analysis, with a time-varying exposure to obesogenic AD (versus non-obesogenic AD) and time-fixed weight status was applied.

Ergebnisse: Of the 1,453 participants, 66.3% were women, the mean age was 53.8 years (standard deviation (SD)=18.7), and 738 (50.8%) had excess weight. The hazard ratio for hospitalizations, adjusted for age, sex, income, level of education, comorbidities, and past health service use (aHR) was 1.84 (95%CI: 1.16, 2.90) in patients jointly exposed to excess weight and obesogenic AD compared to the jointly unexposed group; aHR was 1.50 (95%CI: 0.96, 2.34) and 1.79 (95%CI: 0.87, 3.68) compared to patients with only excess weight or only on obesogenic AD, respectively.

Diskussion: The trend for increased risk of hospitalizations in patients jointly exposed to excess weight and obesogenic AD suggests synergic (super-additive) interactions. Patients with excess weight may benefit less from treatment with obesogenic AD than patients without excess weight.

Take Home Message für die Praxis: When treating patients for depression, special attention should be paid to the patient’s weight status in the selection of antidepressants