EFFECTS OF FLUOXETINE ON INSULIN-RESISTAN CE IN NONDIABETIC OBESE PATIENTS

Fluoxetine, a serotonin re-uptake inhibitor with antidepressive and ap petite reduction effects, could improve insulin sensitivity. The aim o f this work was to assess this effect of fluoxetine in obese subjects. We studied 12 subjects with a body mass index over 30, with a normal oral glucose tolerance test and not subjected to dietary restrictions. Insulin sensitivity using Bergman's minimal model, sex hormone bindin g globulin (SHBG) and insulin like growth factor binding protein 1 (BP 1) were evaluated before and after three weeks of treatment with 60 m g OD of fluoxetine. During treatment, subjects lost a mean of 1.9 kg. When compared with basal values, insulin sensitivity index (S-1)improv ed significantly at the end of treatment (1.71 +/- 0.44 and 2.72 +/- 0 .63 respectively), SHBG increased (28.9 +/- 5.1 and 18.2 +/- 3.4 nM/ml respectively) and BP 1 did not change (2.8 +/- 0.9 and 1.5 +/- 0.3 ng /ml respectively). The changes in insulin sensitivity did not correlat e with weight changes (r= 0.4 NS). Weight or insulin sensitivity chang es did not correlate with initial degree of insulin resistance. We con clude that the improvement in insulin sensitivity elicited by Fluoxeti ne is not related to weight changes and may be useful in the treatment of insulin resistant obese subjects.