Wharton Sean, Raiber Lilian, Serodio Kristin J, Lee Jasmine, Christensen Rebecca Ag
The Wharton Medical Clinic, Toronto, Canada,
School of Kinesiology and Health Science, York University, Toronto, Canada.
Diabetes Metab Syndr Obes. 2018 Aug 21;11:427-438. doi: 10.2147/DMSO.S171365. eCollection 2018.
The cause of the obesity epidemic is multifactorial, but may, in part, be related to medication-induced weight gain. While clinicians may strive to do their best to select pharmacotherapy(ies) that has the least negative impact on weight, the literature regarding the weight effects of medication is often limited and devoid of alternative therapies.
Antipsychotics, antidepressants, antihyperglycemics, antihypertensives and corticosteroids all contain medications that were associated with significant weight gain. However, there are several medication alternatives within the majority of these classes associated with weight neutral or even weight loss effects. Further, while not all of the classes of medication examined in this review have weight-favorable alternatives, there exist many other tools to mitigate weight gain associated with medication use, such as changes in dosing, medication delivery or the use of adjunctive therapies.
Medication-induced weight gain can be frustrating for both the patient and the clinician. As the use of pharmaceuticals continues to increase, it is pertinent for clinicians to consider the weight effects of medications prior to prescribing or in the course of treatment. In the case where it is not feasible to make changes to medication, adjunctive therapies should be considered.
肥胖流行的原因是多方面的,但部分原因可能与药物引起的体重增加有关。虽然临床医生可能会尽力选择对体重负面影响最小的药物治疗方法,但关于药物对体重影响的文献往往有限,且缺乏替代疗法。
抗精神病药、抗抑郁药、降糖药、抗高血压药和皮质类固醇都包含与显著体重增加相关的药物。然而,在这些药物类别中的大多数都有几种与体重中性甚至体重减轻作用相关的替代药物。此外,虽然本综述中研究的并非所有药物类别都有对体重有利的替代药物,但还有许多其他方法可以减轻与药物使用相关的体重增加,例如改变给药剂量、药物递送方式或使用辅助疗法。
药物引起的体重增加对患者和临床医生来说都可能令人沮丧。随着药物使用的持续增加,临床医生在开药前或治疗过程中考虑药物对体重的影响是很有必要的。在无法改变药物的情况下,应考虑辅助疗法。