[The effect of fluoxetine on insulin resistance in non diabetic obese patients]

Fluoxetine, a serotonin re-uptake inhibitor with antidepressive and appetite reduction effects, could improve insulin sensitivity. The aim of this work was to assess this effect of fluoxetine in obese subjects. We studied 12 subjects with a body mass index over 30, with a normal oral glucose tolerance test and not subjected to dietary restrictions. Insulin sensitivity using Bergman's minimal model, sex hormone binding globulin (SHBG) and insulin like growth factor binding protein 1 (BP 1) were evaluated before and after three weeks of treatment with 60 mg OD of fluoxetine. During treatment, subjects lost a mean of 1.9 kg. When compared with basal values, insulin sensitivity index (S1) improved significantly at the end of treatment (1.71 +/- 0.44 and 2.72 +/- 0.63 respectively), SHBG increased (28.9 +/- 5.1 and 18.2 +/- 3.4 nM/ml respectively) and BP 1 did not change (2.8 +/- 0.9 and 1.5 +/- 0.3 ng/ml respectively). The changes in insulin sensitivity did not correlate with weight changes (r = 0.4 NS). Weight or insulin sensitivity changes did not correlate with initial degree of insulin resistance. We conclude that the improvement in insulin sensitivity elicited by Fluoxetine is not related to weight changes and may be useful in the treatment of insulin resistant obese subjects.