The association of antidepressant monotherapy and weight change in a Middle Eastern psychiatric population

Genetic and lifestyle factors influence weight changes secondary to antidepressants. However, the association between antidepressants and weight changes is seldom studied in Middle Eastern populations who have a unique genetic, lifestyle and dietary profile. This is a chart-based retrospective longitudinal study that describes the 6-month evolution of weight in outpatient Lebanese adults initiated on serotonin reuptake inhibitor (SRI) antidepressant monotherapy, with the exclusion of confounders with metabolic implications. A linear mixed model was used to estimate the association of weight with time. Demographic factors were tested for interaction with the model. The sample consisted of 200 antidepressant trials. After adjusting for baseline weight, age, and sex, weight did not change significantly from week 1 to week 4 (P = 0.530) but significantly increased by 0.15 kg/week from week 4 to week 24 (P < 0.05). Sex, baseline weight, alcohol use, tobacco use, and presence of metabolic condition(s) did not affect weight change (P > 0.05). The same changes were observed across all SRIs and diagnoses. Our results show that SRI monotherapy is associated with weight gain throughout the treatment course in a Middle Eastern population. We recommend judicious prescription of SRIs and clinical vigilance over weight throughout the course of treatment in these populations.