Treatment of abdominally obese men with a serotonin reuptake inhibitor: a pilot study

• Published in: Journal of internal medicine Vol. 250; no. 3; pp. 219 - 224
• Main Authors: Ljung, T., Ahlberg, A.‐C., Holm, G., Friberg, P., Andersson, B., Eriksson, E., Björntorp, P.
• Format: Journal Article
• Language: English
• Published: Oxford UK Blackwell Science Ltd 01-09-2001; Blackwell Science; Blackwell Publishing Ltd
• Subjects: abdominal obesity; adverse effects; Biological and medical sciences; blood; Body Constitution; Body Constitution - physiology; Catecholamines; Catecholamines - urine; Citalopram; Citalopram - adverse effects; Citalopram - therapeutic use; Cross-Over Studies; depression; Double-Blind Method; drug effects; drug therapy; Farmakologi och toxikologi; Glucose Tolerance Test; Humans; Hydrocortisone; Hydrocortisone - blood; hypothalamic‐pituitary‐adrenal axis; Hypothalamo-Hypophyseal System; Hypothalamo-Hypophyseal System - drug effects; Hypothalamo-Hypophyseal System - physiopathology; Insulin; Insulin - blood; Male; Medical sciences; Metabolic diseases; Middle Aged; Obesity; Obesity - drug therapy; Obesity - physiopathology; Pharmacology and Toxicology; physiology; physiopathology; Pituitary-Adrenal System; Pituitary-Adrenal System - drug effects; Pituitary-Adrenal System - physiopathology; serotonin reuptake inhibition; Serotonin Uptake Inhibitors; Serotonin Uptake Inhibitors - adverse effects; Serotonin Uptake Inhibitors - therapeutic use; Sympathetic Nervous System; Sympathetic Nervous System - drug effects; Sympathetic Nervous System - physiopathology; therapeutic use; urine; Human; Obesity; Serotonin; Psychotropic; Nutrition disorder; Male; Reuptake inhibitor; Crossover study; Abdomen; Citalopram; Chemotherapy; Treatment; Autonomic nervous system; Abdominal disease; Placebo; Double blind study; Antidepressant agent; Endocrinology; Nutritional status
• ISSN: 0954-6820; 1365-2796; 1365-2796
• DOI: 10.1046/j.1365-2796.2001.00881.x

. Ljung T, Ahlberg A‐C, Holm G, Friberg P, Andersson B, Eriksson E, Björntorp P (Sahlgrenska University Hospital and University of Göteborg, Göteborg, Sweden). Treatment of abdominally obese men with a serotonin reuptake inhibitor: a pilot study. J Intern Med 2001; 250: 219–224.
Objective. To investigate the effects of a selective serotonin reuptake inhibitor (SSRI) on the neuroendocrine and autonomic nervous system perturbations found in abdominal obesity.
Design. Treatment for 6 months with citalopram and for 6 months with placebo using a double‐blind, cross‐over design, with a 2‐month wash‐out period between treatment periods.
Subjects. Sixteen healthy men, 45–60 years, moderately obese and with an abdominal fat distribution.
Measurements. Anthropometry, three different depression rating scales, serum lipids, testosterone, IGF‐I, oral glucose tolerance test (OGTT), pituitary stimulation with corticotropin releasing hormone (CRH), arithmetic stress test, and excretion of cortisol and metoxycatecholamines in urine, collected during 24 h.
Results. Cortisol concentrations in the morning were low before treatment, indicating a perturbed function of the hypothalamic‐pituitary‐adrenal (HPA) axis. After treatment with citalopram morning cortisol concentrations rose to normal. Cortisol concentrations after stimulation with CRH or stress were elevated by citalopram treatment, but urinary cortisol excretion was unchanged. The glucose concentrations after OGTT (120 min) tended to be reduced, with unchanged insulin concentrations, whilst other metabolic values did not change during treatment. Heart rate after administration of CRH, and during laboratory stress test, decreased by treatment with citalopram. Diurnal urinary excretion of metoxycatecholamines tended to decrease. Neither body mass index nor waist/hip circumference ratio decreased. Depression scores were within normal limits before treatment and did not change.
Conclusion. The results of this pilot study indicate improvements in the regulation of neuroendocrine‐autonomic systems as well as metabolism in abdominal obesity during treatment with an SSRI.