O uso off-label de antidepressivos para o emagrecimento: uma revisão de literatura

Abstract

Obesity, a global chronic disease, is influenced by a variety of factors and represents a significant challenge to public health. The diagnosis is made mainly through the Body Mass Index (BMI). The BMI is used to assess obesity and overweight, conditions associated with health issues such as cardiovascular diseases, diabetes, and cancer. Predictions suggest that by 2025, the number of obese individuals worldwide could reach 300 million. In Brazil, data from the National Health Survey revealed that in 2015, approximately 82 million Brazilians were already overweight. Prevention and treatment of obesity involve interventions ranging from lifestyle changes to more invasive therapies, including bariatric surgery and drug therapy. This study aims to conduct a literature review on the off-label use of antidepressants for weight loss, seeking to assess their effectiveness, safety, and clinical implications. The research is based on a narrative literature review spanning from 2006 to 2023, conducted in the PUBMED database, with eligibility criteria including studies exploring the off-label use of antidepressants for weight loss. The results were obtained through the analysis of six articles, comprising two narrative reviews, two systematic reviews, one retrospective cohort study, and one randomized clinical trial. These articles revealed three antidepressant medications with a higher level of evidence for weight loss: bupropion stands out as the most effective treatment for overweight and binge eating, sertraline has a modest influence when used for this purpose, and fluoxetine aids weight loss by inhibiting hunger signals. However, it was observed that there is a lack of robust clinical trials in this area. Due to this scarcity of clear evidence, this study emphasizes the need for additional research to inform safe and effective clinical decisions in the treatment of obesity with antidepressants.