Psychiatry Investig.  2013 Jun;10(2):148-154.

Relationship between SSRIs and Metabolic Syndrome Abnormalities in Patients with Generalized Anxiety Disorder: A Prospective Study

• Beyazyuz M
• Albayrak Y
• Egilmez OB
• Albayrak N
• Beyazyuz E

Abstract

OBJECTIVE
SSRIs are some of the most widely prescribed medications in the world. In addition to their effectiveness, SSRIs were reported to be associated with the side effects of weight gain, sexual dysfunction, drug interactions, extrapyramidal symptoms and discontinuation symptoms. However, the effects of SSRIs on metabolic parameters are poorly understood.
METHODS
This study aims to describe the effects of SSRIs on the metabolic parameters of drug-naive first episode patients with generalized anxiety disorder. Ninety-seven female patients aged 20-41 years without any metabolic or psychiatric comorbidity were included in the study. Fluoxetine, sertraline, paroxetine, citalopram and escitalopram were randomly given to the patients. Metabolic parameters, including BMI, waist circumference and the levels of fasting glucose, total cholesterol, triglyceride, HDL, LDL and blood pressure, were measured before and after 16 weeks of treatment.
RESULTS
In the paroxetine group, there was a significant increase in the parameters of weight, BMI, waist circumference, fasting glucose, total cholesterol, LDL and triglyceride after 16 weeks of treatment. There were significant increases in the levels of triglyceride in the citalopram and escitalopram groups. In the sertraline group, the total cholesterol level increased after treatment. In the fluoxetine group, there were significant reductions in the parameters of weight, total cholesterol and triglyceride.
CONCLUSION
To our knowledge, this study is the first to prospectively describe metabolic syndrome abnormalities in patients with first episode generalized anxiety disorder. Although the effectiveness of the different SSRIs is similar, clinicians should be more careful when prescribing SSRIs to patients who have cardiac risk factors. Larger and lengthier controlled clinical trials are needed to explore the associations between SSRI use and metabolic syndrome.

Keyword

Metabolic syndrome; SSRI; Side effect; Prospective; Anxiety

MeSH Terms

Aged
Anxiety
Anxiety Disorders
Blood Pressure
Cholesterol
Cholesterol, LDL
Citalopram
Comorbidity
Drug Interactions
Fasting
Female
Fluoxetine
Glucose
Humans
Paroxetine
Prospective Studies
Risk Factors
Sertraline
Waist Circumference
Weight Gain
Cholesterol
Cholesterol, LDL
Citalopram
Fluoxetine
Glucose
Paroxetine
Sertraline