Influence of antidepressant therapies on weight and appetite in the elderly.

OBJECTIVE: Determine the nutritional impact of antidepressant drugs in elderly.
METHODS: The study included 139 independently mobile out-patients managed by the Poitiers geriatric day hospital for problems of loss of home support, rehabilitation and medical or psychological care, with a stable treatment for 3 months at the time of inclusion and over the 3 months of the study. The study addressed the time course of nutritional parameters from baseline to 3 months post-inclusion. The physical examination included monthly weighing of the patients, 3-monthly evaluation of nutritional status using the Mini Nutritional Assessment (MNA) instrument and serum albumin.
RESULTS: 52 men (76.3 +/- 6.7 years [62-87]) and 87 women (81.0 +/- 7.2 years [65-100]) were included. Seventy-nine patients presented with dementia. Seventy-four patients were receiving an antidepressant, of which 54 serotonin reuptake inhibitors. The patients free from dementia and not receiving antidepressants had nutritional indices that did not vary over the study period. The dementia-free patients receiving antidepressants gained weight (1.44 kg) - 1.87 kg on serotonin reuptake inhibitors - showed an improvement in MNA of 0.76/30 and showed a significant improvement in serum albumin of 1.78 g/L. The demented patients not receiving antidepressants lost weight (-1.01 kg), MNA score fell and serum albumin significantly decreased. On antidepressants, the demented patients significantly gained weight (0.73 kg) while no deterioration in the other parameters reflecting undernutrition was observed. Conclusions. In the middle term, in elderly subjects, antidepressants do not induce undernutrition or weight loss. Irrespective of antidepressant type, those agents seem to prevent weight loss in elderly subjects presenting with dementia.