(248) The Role of The Excess Weight Status in The Risk of Hospitalizations for Patients with Depression Prescribed Obesogenic Antidepressants

Saturday, August 27, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 922

Presenting Author(s)

Svetlana Puzhko, PhD
– Dr., Bielefeld University, University of Bielefeld, Bielefeld, Germany

Co-Author(s)

Tibor Schuster, PhD
– Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
Christel Renoux, MD PhD
– Associate Professor, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada., Canada
Tracie A. Barnett
– McGill University, Canada
Kimberly Munro
– McGill University, Canada
Gillian Bartlett-Esquilant, PhD, FISPE
– Professor, University of Missouri School of Medicine, Columbia, Missouri, United States

Background: Patients with excess weight may have poor response to certain antidepressants (AD) and may be more vulnerable to negative consequences of weight increasing (obesogenic) adverse effects. It is important to evaluate the need to implement a differential approach to AD selection for this population.

Objectives: Our objectives were to estimate the difference in risk for all-cause hospitalizations between people with and without excess weight who were prescribed obesogenic AD, and to quantify the association between the use of individual obesogenic AD and hospitalizations between these groups.

Methods: The population-based cohort “The Care Trajectories - Enriched Data” (“TorSaDE”) was used, where the data for the biennial Statistics Canada survey for 2007-2014 were linked with longitudinal health-administrative data. The cohort of incident users of AD, with depression diagnosed and weight status measured before the first AD prescription, was extracted. We examined the role of excess weight before the first AD prescription in the association between exposure to obesogenic AD and all-cause hospitalizations during the 12 months of treatment. We applied Cox regression analysis, with a time-varying exposure to obesogenic AD (versus non-obesogenic AD) and time-fixed weight status, and cosine similarity method.

Results: Of the 1,453 participants, 66.3% were women, mean age was 53.8 years (standard deviation (SD)=18.7), and 738 (50.8%) had excess weight. The hazard ratio for hospitalizations, adjusted for age, sex, income, level of education, comorbidities, and past health service use (aHR) was 1.84 (95%CI: 1.16, 2.90) in patients jointly exposed to excess weight and obesogenic AD compared to the jointly unexposed group; aHR was 1.50 (95%CI: 0.96, 2.34) and 1.79 (95%CI: 0.87, 3.68) compared to patients with only excess weight or only on obesogenic AD, respectively. Differences in cosine similarity between contrasting weight groups were observed for amitriptyline and nortriptyline but not for mirtazapine and paroxetine.

Conclusions: Patients with excess weight may benefit less from treatment with obesogenic AD than patients without excess weight. The role of excess weight in the association between exposure to obesogenic AD and hospitalizations may depend on specific obesogenic AD.