[Obesity, type 2 diabetes and depression : which metabolic impact of antidepressants ?]

Abstract

Metabolic disorders (dysglycaemia, dyslipidaemia, metabolic syndrome) may occur or worsen with antidepressants. Even if the metabolic risk appears lower with antidepressants than with certain atypical antipsychotics, it should not be neglected in clinical practice, especially with antidepressants that are associated with weight gain. Metabolic disorders may occur with both selective serotonin reuptake inhibitors and tricyclics, but with some between-molecule differences within each pharmacological family. Besides potential deleterious effects of medications, the psychiatric population is also exposed to bad lifestyle habits (unhealthy diet and sedentary life) and poor medication compliance, which all together could also contribute to enhance the risk of metabolic disorders and cardiovascular complications. Facing such a complex situation, it is not easy to individualize the metabolic risk inherent to antidepressants, also because an effective management of the depression could improve both the quality of life and the adherence to a better lifestyle.