ISTANBUL, TURKEY — The use of tricyclic antidepressants to treat depression and/or anxiety was associated with a sharply increased risk of metabolic syndrome, compared with other antidepressant classes, in a large Dutch study.
Tricyclic antidepressants (TCAs) were tied to exacerbations of hypertension, abdominal obesity, and hypertriglyceridemia, Arianne K.B. van Reedt Dortland said at the annual congress of the European College of Neuropsychopharmacology. This analysis from NESDA (the Netherlands Study of Depression and Anxiety) shows the need to screen for these elements in patients who are being considered for TCA therapy or who are already on it, so an alternative type of antidepressant can be considered, said Ms.
van Reedt Dortland of Leiden (the Netherlands) University Medical Center.
NESDA is an ongoing 8-year prospective multicenter study involving 261 patients with major depressive disorder alone, 266 with acpure anxiety disorder, and 690 with both.
During the first 4 years of follow-up, patients on a TCA had a 2.3-fold increased risk of meeting criteria for metabolic syndrome after adjustment for confounding factors, compared with patients not on antidepressant medication. Patients on TCA therapy weso had a 2.3-fold increased risk for hypertension, 1.9-fold increased risk for abdominal obesity, and 2.6-fold increased risk for hypertriglyceridemia. The use of SSRIs or selective norephinephrine reuptake inhibitors was not associated with risk of metabolic syndrome.
Dr. Dortland reported having no conflicts of interest.