Does Long-Term Post-Bariatric Weight Change Differ Across Antidepressants?

Autor: David E. Arterburn, MD, MPH, Matthew L. Maciejewski, PhD, Theodore S. Z. Berkowitz, MS, Valerie A. Smith, DrPH, James E. Mitchell, MD, Chuan-Fen Liu, PhD, Adenike Adeyemo, MPH, Katharine A. Bradley, MD, Maren K. Olsen, PhD
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Annals of Surgery Open, Vol 3, Iss 1, p e114 (2022)
Druh dokumentu: article
ISSN: 2691-3593
00000000
DOI: 10.1097/AS9.0000000000000114
Popis: Objectives:. We sought to evaluate whether weight change up to 5 years after bariatric surgery differed by antidepressant class taken before surgery. Background:. Bariatric surgery induces significant weight loss, but outcomes are highly variable. The specific type of antidepressant used prior to surgery may be an important factor in long-term weight loss. Methods:. This retrospective cohort study from 2000 to 2016 compared the 5-year weight loss of 556 Veterans who were taking antidepressant monotherapy (bupropion, selective serotonin reuptake inhibitors [SSRIs], or serotonin-norepinephrine reuptake inhibitors [SNRIs]) before bariatric surgery (229 sleeve gastrectomy and 327 Roux-en-Y gastric bypass) versus 556 matched nonsurgical controls. Results:. Patients taking bupropion before sleeve gastrectomy had greater differential weight loss between surgical patients and matched controls than those taking SSRIs at 1 (8.9 pounds; 95% confidence interval [CI], 1.6–16.3; P = 0.02) and 2 years (17.6 pounds; 95% CI, 5.9–29.3; P = 0.003), but there was no difference at 5 years (11.9 pounds; 95% CI, –8.9 to 32.8; P = 0.26). Findings were similar for gastric bypass patients taking bupropion compared to SSRIs at 1 (9.7 pounds; 95% CI, 2.0–17.4; P = 0.014), 2 (12.0 pounds; 95% CI, –0.5 to 24.5; P = 0.06), and 5 years (4.8 pounds; 95% CI, –16.7 to 26.3; P = 0.66). No significant differences were observed comparing patients taking SNRI versus SSRI medications. Conclusions:. Sleeve gastrectomy and gastric bypass patients taking bupropion had greater weight loss than those taking SSRIs, although these differences may wane over time. Bupropion may be the first-line antidepressant of choice among patients with severe obesity considering bariatric surgery.
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