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Several commonly prescribed drugs affect weight
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Several commonly prescribed drugs are associated with varying degrees of weight change, according to recent findings.
“An expert panel from The Endocrine Society is charged with developing clinical practice guidelines for the management of obesity,” the researchers wrote. “As part of a comprehensive management approach, medication choice can play a role. To aid in the development of the Society guidelines, we conducted this systematic review and meta-analysis aimed at summarizing the evidence about commonly prescribed drugs and their associations with weight loss or weight gain. The goal is to provide patients and clinicians with information that can inform and individualize treatment decisions.”
M. Hassan Murad, MD, of the Mayo Clinic, Knowledge and Evaluation Research Unit, and colleagues used an umbrella search strategy to query databases for published systematic reviews as a source of randomized clinical trials. Studies identified for inclusion compared a selected list of drugs to placebo and evaluated their effects on weight. The researchers identified 257 randomized controlled trials that assessed the impact on weight of 54 different drugs.
M. Hassan Murad
Classes of drugs included atypical antipsychotics, hypoglycemic agents, antihypertensive agents, anticonvulsants/mood stabilizers, hormones, antidepressants and antihistamines.
The researchers found that the following drugs were associated with weight gain: amitriptyline (1.8 kg), mirtazapine (1.5 kg), olanzapine (2.4 kg), quetiapine (Seroquel, AstraZeneca; 1.1 kg), risperidone (0.8 kg), gabapentin (2.2 kg), tolbutamide (2.8 kg), pioglitazone (2.6 kg), glimepiride (2.1 kg), gliclazide (1.8 kg), glyburide (2.6 kg), glipizide (2.2 kg), sitagliptin (0.55 kg) and nateglinide (Starlix, Novartis; 0.3 kg). Overall, atypical antipsychotics were associated with the most weight gain.
Weight loss was observed in association with metformin (1.1 kg), acarbose (Precose, Bayer; 0.4 kg), miglitol (Glyset, Pfizer; 0.7 kg), pramlintide (Symlin, AstraZenca; 2.3 kg), liraglutide (1.7 kg), exenatide (1.2 kg), zonisamide (7.7 kg), topiramate (3.8 kg), buproprion (1.3 kg) and fluoxetine (1.3 kg).
In the cases of several of the other drugs evaluated, changes in weight were deemed either statistically insignificant or backed by low-quality evidence.
“The summarized evidence herein will help in treatment choice when several options are available,” the researchers wrote. “In addition, it may help with instituting preemptive weight loss strategies when prescribing certain drugs. For example, the large and quick effect of atypical antipsychotics on weight suggests that some preemptive weight management measures should be undertaken when prescribing these drugs.” – by Jennifer Byrne
Disclosure: The researchers report no relevant financial disclosures.
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