SSRIs and Weight Gain: Balancing Outcomes for Optimal Management
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The purpose of this paper is to analyze available evidence related to the use of SSRIs and weight gain during the treatment of depression. Based on this review, nursing care implications aimed at improving outcomes are explored. Depression affects millions of people and the direct and indirect costs of depression have risen to over 40 billion dollars each year. Depression can be treated successfully. However, recurrence occurs in 50% of the population. Selective serotonin re-uptake inhibitors (SSRIs) are the most common antidepressant prescribed today because of their ease of use, tolerability and reduced risk of overdose. The current SSRIs approved for depression include fluoxetine, paroxetine, sertraline, citalopram and escitalopram. Studies have documented problems of unwanted weight gain with SSRIs. Weight gain occurs most often after prolonged treatment with SSRIs although weight loss is common during the first few weeks of treatment. This weight gain may be considered a deferent pharmacological adherence with depressed patients. Kozma's, Reeder's, and Schulz's (1993) framework, The Economic, Clinical and Humanistic (ECHO) Model has been used to guide the analysis of existing research related to the treatment of depression using SSRIs and possible weight gain. This conceptual framework combines the traditional medical model with humanistic and economic outcomes and guides the analysis formulated in this paper. Nursing has the opportunity and responsibility to help patients cope with unwanted weight gain. Treatment strategies may include proactive education including nutrition counseling, exercise therapy, and weekly weight measurements. Partnerships between practitioners, nursing teams, and patients may empower patients to prevent unwanted weight gain while optimizing the outcomes of depression treatment.