Salvador, BA (Folhapres) – Although the prescription of antidepressants to deal with weight problems is taken into account adequate by specialists in some circumstances, sufferers complain of insecurity and lack of knowledge about the usage of the medicine. Fluoxetine, sertraline, and bupropion hydrochloride are probably the most advisable within the workplace.
According to Fabio Trujillo, director of the weight problems part at SBEM (Brazilian Society of Endocrinology and Metabolism) and vice chairman of ABESO (Brazilian Association for the Study of Obesity and Metabolic Syndrome), the organizations he represents really feel it’s applicable to prescribe antidepressants. An various is advisable for sufferers who haven’t responded satisfactorily to particular medicines for this objective, corresponding to sibutramine and orlistat, supplied weight problems therapy.
Off-label use of medication to deal with ailments aside from these specified on the package deal and permitted by Anvisa (Brazilian Health Surveillance Agency) is taken into account to be off-label. Although there is no such thing as a producer suggestion, most medicine used for functions aside from these indicated are supported by scientific research proving their effectiveness, Trujillo says.
In a observe, Anvisa states that “it doesn’t regulate off-label use. However, this use should be primarily based on scientific proof and should be justified by the doctor’s duty to evaluate every affected person’s scientific situation”.
According to Durval Ribas, president of Abran (Brazilian Association of Nutrology), some antidepressants work for weight loss as a result of they act on the central nervous system in the identical approach that almost all anti-obesity medicine do.
“It was found that some antidepressants had results on the central nervous system associated to neurotransmitters that had been instantly associated to urge for food and satiety mechanisms,” says Ribas.
Although professionals state that prescription is advisable in some circumstances, sufferers complain of insecurity and lack of knowledge.
Maria (not her actual title by request) says that regardless of dropping weight the primary few months she took fluoxetine, she gained the weight again and noticed no long-term advantages. In addition to the accordion impact, she reported nausea and irritability as disadvantages of therapy carried out by an endocrinologist.
According to her, insecurity in taking antidepressants was additionally a drawback as medical doctors didn’t correctly clarify the explanation for the prescription.
“I believe more often than not medicine are given with out giving the particular person different choices”, he says. After turning into pissed off with the therapy, she determined to accentuate her food regimen and train.
One such case is that of Ana Paula Sequeira, 54, a public relations skilled who took antidepressants twice in her life to deal with weight problems. Although at all times medically indicated, Sequeira felt unhealthy in regards to the therapy. She thinks the prescription wasn’t sufficient.
Encouraged by her psychologist, Sequeira stopped utilizing Certline after solely 10 days of use. “I felt responsible,” she says.
After the expertise, she misplaced 10 kg by food regimen and train. Today, it focuses its consideration on one of these therapy as a result of it considers it a extra pure technique than utilizing injections to deal with pre-diabetes.
For José Carlos Apolinario, psychiatrist and coordinator of the Eating Disorders Commission of the ABP (Brazilian Association of Psychiatry), antidepressants should solely be used to deal with weight problems in any case different choices have been exhausted. According to him, there are not sufficient research to ensure the effectiveness of long-term therapy.
Psychiatrists clarify that whereas this isn’t proof for the medicine’ remoted use, Anvisa has left the connection of bupropion with naltrexone, a drug used to deal with anti-obesity, opiates and alcohol dependancy.
According to Apolinario, a affected person who receives a prescription for antidepressants for weight loss should comply with up with a psychiatrist every time doubtful.
Endocrinologist Fabio Trujillo confirmed that not all remedies require remedy, but that the usage of remedy should be clarified for those that want it.
“Well-prescribed medicine, in the correct dose for the correct particular person, will assist. But we additionally see indiscriminate use and prescriptions that are not sufficient”, he says.
According to Trujillo, the drug is indicated for sufferers who’ve a BMI (physique mass index) larger than 30 and whose weight has not been misplaced by way of life modifications alone. People with a BMI larger than 27 and different obesity-related comorbidities, corresponding to osteoarthritis or fatty liver, additionally match this indication.
Doctors say that the best way professionals method the topic can also be essential. According to him, the correct factor is to elucidate the choices to the sufferers, who have to have an energetic angle in the course of the session and to not impose the kind of therapy.
Finally, Trujillo declares that the affected person should by no means self-medicate or search therapy with out knowledgeable follow-up. The dangers of utilizing medicine with out medical supervision are many, corresponding to worsening hypertension, cardiovascular problems, tachycardia, emotional imbalance and demise, he says.