Body weight as a predictor of antidepressant efficacy in the GENDEP project

作者：Uher Rudolf^*; Mors Ole; Hauser Joanna; Rietschel Marcella; Maier Wolfgang; Kozel Dejan; Henig**erg Neven; Souery Daniel; Placentino Anna; Perroud Nader; Dernovsek Moica Zvezdana; Strohmaier Jana; Larsen Erik Roj; Zobel Astrid; Leszczynska Rodziewicz Anna; Kalember Petra; Pedrini Laura; Linotte Sylvie; Gunasinghe Cerisse; Aitchison Katherine J; McGuffin Peter; Farmer Anne

来源：Journal of Affective Disorders, 2009, 118(1-3): 147-154.

DOI：10.1016/j.jad.2009.02.013

• Depression
• Antidepressant medication
• Body weight
• Body mass index
• Psychopharmacology
• Psychosomatics

Background: Being overweight or obese may be associated with poor response to antidepressants. The present report explores the moderation of antidepressant response by body weight to establish the specificity to antidepressant mode of action, type of depressive symptoms and gender.
Methods: Height and weight were measured in 797 men and women with major depression treated with escitalopram or nortriptyline for twelve weeks as part of the Genome Based Therapeutic Drugs for Depression (GENDEP) project. Body mass index (BMI) and obesity (BMI>30) were tested as predictors of change in depressive symptoms using mixed linear models.
Results: Higher BMI and obesity predicted poor response to nortriptyline but did not significantly influence response to escitalopram. The moderation of response by body weight was due to differential improvement in neurovegetative symptoms, including sleep and appetite. The relationship between body weight and change in neurovegetative symptoms was moderated by gender with obese men responding less to nortriptyline and obese women having poorer response to both antidepressants. Limitations: As no placebo arm was included, the specificity of findings to antidepressants is relative. Lack of specific measures precluded accounting for differences in body fat distribution.
Conclusions: Body weight should be considered in the assessment of depression as it may inform the selection of antidepressant treatment.

• 出版日期2009-11
• 单位上海市精神卫生中心