Fluoxetine versus sertraline and paroxetine in major depressive disorder: Changes in weight with long-term treatment

Background: The effects of extended selective serotonin reuptake inhibitor (SSRI) treatment on weight are not well characterized. Also unknown is whet her different agents have differential effects. To examine these questions, we assessed weight changes in patients randomly assigned to long-term trea tment with fluoxetine, sertraline, or paroxetine. Method: Patients (N = 284) with major depressive disorder (DSM-IV) were ran domly assigned to double-blind treatment with fluoxetine (N = 92), sertrali ne, (N = 96), or paroxetine (N = 96) for a total of 26 to 32 weeks. The mea n percent change in weight was compared for each group, as was the number o f patients who had greater than or equal to 7% weight increase from baselin e. Results: Patients (fluoxetine, N = 44; sertraline, N = 48; paroxetine, N = 47) who completed the trial were included in these analyses. Paroxetine-tre ated patients experienced a significant weight increase, fluoxetine-treated patients had a modest but nonsignificant weight decrease, and patients tre ated with sertraline had a modest brit nonsignificant weight increase. The number of patients whose weight increased greater than or equal to 7% from baseline was significantly greater For paroxetine treated compared with eit her fluoxetine-treated or sertraline-treated patients, Conclusion: Risk of weight gain during extended SSRI treatment differs depe nding on which SSRI is used.