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Breast enlargement during chronic antidepressant therapy
J D Amsterdam1, F Garcia-España, D Goodman
1Department of Psychiatry, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
Journal of Affective Disorders
|February 28, 1998
Summary
Selective serotonin reuptake inhibitor (SSRI) therapy may cause breast enlargement (mammoplasia) more often than expected. This side effect is linked to weight gain and is more common with SSRIs than venlafaxine.
Area of Science:
- Endocrinology
- Pharmacology
- Women's Health
Background:
- Recent reports suggest mammoplasia (breast enlargement) is a potential side effect of selective serotonin reuptuptake inhibitor (SSRI) therapy.
- The actual incidence and associated factors of antidepressant-induced mammoplasia require further investigation.
Purpose of the Study:
- To investigate the incidence of mammoplasia in women undergoing treatment with SSRIs or venlafaxine.
- To explore the relationship between mammoplasia and menopausal status, weight gain, and duration of drug therapy.
- To assess hormonal changes, including prolactin and estradiol, associated with antidepressant-induced mammoplasia.
Main Methods:
- A study involving 59 women treated for at least two months with SSRIs or venlafaxine.
- Data collection included patient-reported breast size changes, menopausal status, weight changes, and treatment duration.
- Serum prolactin, estradiol, and beta-hCG levels were measured before and during treatment in a subset of patients.
Main Results:
- 39% (23 out of 59) of patients reported some degree of mammoplasia.
- Mammoplasia was significantly more frequent in patients taking SSRIs compared to venlafaxine (p < 0.01).
- Weight gain was strongly associated with mammoplasia (84% with mammoplasia vs. 30% without, p < 0.001).
- No significant association was found between mammoplasia and age, menopausal status, or treatment duration.
- Serum prolactin levels increased during treatment in the paroxetine subgroup (p < 0.03).
Conclusions:
- Antidepressant-induced mammoplasia appears to be more common than previously recognized.
- SSRIs are more frequently associated with mammoplasia than venlafaxine.
- Weight gain is a significant contributing factor to antidepressant-induced mammoplasia.