Comparing the effects of fluoxetine and imipramine on total cholesterol, triglyceride, and weight in patients with major depression

Abstract

BackgroundThere are some reports on the effects of antidepressants on metabolic syndrome. However, our search in the previously published literature showed a lack of information on the comparison of the effects of different classes of antidepressants on lipid profile. Therefore, this study was aimed to compare the effects of fluoxetine and imipramine on serum total cholesterol (TC) and triglyceride (TG) as well as body weight (BW) in patients with major depressive disorder.MethodsFifty one patients, 18 to 70 years of age, with major depressive disorder complied with the criteria of this preliminary, open-label clinical trial. Subjects received either imipramine (75–200 mg/day) or fluoxetine (20–40 mg/day) for 8 weeks. Total cholesterol and TG levels, as well as BW were compared at baseline with those at weeks 4 and 8. Data was analyzed by SPSS software version 16.0.ResultsIn the fluoxetine group, TC levels decreased from 165.71 mg/dL to 156.71 mg/dL at week 4 (P = 0.07), and to 143.94 mg/dL at week 8 (P = 0.16); TG levels decreased from 129.35 mg/dL to 115.88 mg/dL at week 4 (P <0.001), and to 110.41 mg/dL at week 8 (P = 0.56). In the imipramine group, TC levels increased from 169.10 mg/dL to 178.69 mg/dL at week 4 (P = 0.07), and to 208.69 mg/dL at week 8 (P < 0.001) while TG levels increased from 111.73 mg/dL to 128.83 mg/dL at week 4 (P = 0.005), and to 160.90 mg/dL at week 8 (P < 0.001). BW was significantly increased in the imipramine group at weeks 4 and 8. In the fluoxetine group, BW was non-significantly decreased from 75.69 ± 7.97 Kg (baseline) to 75.67 ± 8.01 Kg at week 4 (P = 0.88), and to 75.22 ± 8.67 Kg at week 8 (P = 0.20), while in the imipramine group, BW had significant increases from 72.53 ± 8.55 Kg (baseline) to 73.95 ± 8.61 mg/dL at week 4 (P < 0.001), and to 75.13 ± 8.34 mg/dL at week 8 (P < 0.001).Repeated measures ANOVA showed significant effects on both TC and TG levels as well as on BW in all patients receiving imipramine. However, in patients on fluoxetine, repeated measures ANOVA showed significant effects of this medication only on TC levels in males.ConclusionsMonitoring TC and TG and BW is recommended before starting imipramine in depressed patients with increased risk for cardiovascular disease. Fluoxetine may be the preferred agent in those with high or borderline high lipid levels.

The Effects of Antidepressants “Fluoxetine and Imipramine” on Vascular Abnormalities and Toll Like Receptor-4 Expression in Diabetic and Non-Diabetic Rats Exposed to Chronic Stress

“…The present work emphasizes the improvement of metabolic and vascular effects induced by DM and CRS with chronic fluoxetine treatment in contrast to no improvement or even worsening of these effects with imipramine. Several previous studies have reported the favorable effect of chronic fluoxetine treatment on blood glucose and lipids [ 41 , 42 ]; this effect may be due to improvement of insulin sensitivity which is noticed in this work, fluoxetine also have an antioxidant effect [ 43 ]. Breum et al [ 44 ] reported that chronic fluoxetine treatment improved glycemic control in patients with NIDDM with improvement of insulin sensitivity.…”

“…Moreover, Ghaeli et al [ 41 ] and Salehi and Sanjani [ 52 ] revealed increase in fasting blood glucose upon chronic treatment with imipramine. Ananloo et al [ 42 ] reported increased serum total cholesterol, triglyceride and body weight in depressive patients treated with imipramine. Indeed, previous reports revealed imipramine-induced dyslipidemia, insulin resistance and endothelial dysfunction in CMS model [ 53 ], but this is the first study showing this observation in CRS paradigm.…”

Large-scale microfluidics providing high-resolution and high-throughput screening of Caenorhabditis elegans poly-glutamine aggregation model

“…One of these four compounds, dronedarone (S2114), is used in therapy for the treatment of patients with paroxysmal and persistent arterial fibrillation or atrial flutter 46 . The second compound, tofranil (SAM002564216), a strong serotonin reuptake blocker, is mainly used in the treatment of depression 47 . The third compound, bendrofluazide (SAM002264598), is used for treatment of hypertension.…”

The antidepressant-like activity of AC-5216, a ligand for 18KDa translocator protein (TSPO), in an animal model of diabetes mellitus

“…Also, Flu enhanced the insulin sensitivity in obese patients and ameliorated the function of pancreatic β-cell secretory in drug-naive major depressive disorder (MDD) patients6566. In addition, when it came to TC and TG, data showed that both of the parameters were decreased by chronic Flu treatment in patients with MDD67. Partially in line with Met (1.8 mg/kg, i.p), Flu (10.8 mg/kg, i.p) and MF, HFD-STZ-induced effects on PG (Fig.…”