年轻人开始服用抗抑郁药物和坚持服用抗抑郁药物的比较BMI-z变化
Sheryl L Rifas-Shiman1, Jessica G Young2, Han Yu1
1Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
Journal of the American Academy of Child and Adolescent Psychiatry
|November 22, 2025
概括
在年轻人中,布普罗的开始和坚持并没有显著改变BMI-z,与其他四种与BMI-z小幅增加相关的抗抑郁药不同. 临床医生在给年轻患者开抗抑郁药时应该考虑这些发现.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 心理药理学 心理药理学
- 公共卫生 公共卫生
背景情况:
- 抗抑郁药的使用在年轻人中越来越多.
- 体重增加是抗抑郁药的常见副作用,影响了坚持和代谢健康.
- 了解儿童群体BMI-z对药物特异性的影响至关重要.
研究的目的:
- 模拟一个目标试验,评估开始和坚持特定抗抑郁药物对年轻人身体质量指数-z (BMI-z) 变化的影响.
- 为了比较12个月内塞特拉林,素,埃斯基塔洛普拉姆,西塔洛普拉姆和布鲁波对BMI-z的影响.
主要方法:
- 在11个美国医疗保健系统 (2010-2019) 中,分析了来自67,039名年龄在5岁至19.5岁以下的患者的电子健康记录.
- 利用处方数据来评估五种常见抗抑郁药的启动和坚持.
- 应用边际结构模型的反向概率权重,以估计12个月和6个月BMI-z变化对人口水平的影响.
主要成果:
- 启动和坚持布罗皮昂治疗与12个月BMI-z显著变化无关 (平均变化=-0.06).
- 塞特拉林,西塔洛普拉姆,埃斯卡托普拉姆和弗洛克塞丁与12个月的0.10至0.18个单位的小平均BMI-z增长有关.
- 与塞特拉林相比,布鲁显示了统计学上显著的较低的BMI-z变化 (-0.15),尽管其他比较并不显著.
结论:
- 年轻人开始服用布和坚持服用布并没有与12个月的BMI-z变化有关.
- 其他四种常见的抗抑郁药在12个月内BMI-z略有增加.
- 处方医生在为儿科患者选择抗抑郁药时,应该考虑这些BMI-z差异,以及疗效和安全性数据.
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