Effects of antidepressant type on allostatic load of male and female psychiatric outpatients

Abstract

Sex differences and antidepressant use are not systematically accounted for in studies measuring physiological dysregulations associated with chronic stress and allostatic load (AL) in neuropsychiatry. Critically, assessing commonly prescribed antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) and selective serotonin and norepinephrine reuptake inhibitors (SNRIs) could help monitor potential iatrogenic effects on AL and health that are associated with prolonged antidepressant use. The objective of this exploratory analysis was to investigate how male and female psychiatric outpatients using either SSRIs or SNRIs differ in their AL indices. To achieve this, we used data from a larger project collecting administrative, medical, and biological data among psychiatric outpatients of the Anjou Clinic for Mood and Anxiety Disorders, based in Montreal, Canada (n = 116). Sociodemographic variables included age and birth-assigned sex. We calculated AL using 10 biomarkers reflecting cardiovascular (systolic blood pressure, diastolic blood pressure, pulse) and metabolic (glucose, creatinine, total cholesterol, high density lipoprotein cholesterol (HDL), total cholesterol/HDL ratio, triglycerides, body mass index) functioning. Psychiatric medications were classified using the Anatomical and Therapeutic Classification system. We found that relative to female outpatients, male outpatients showed significantly higher AL levels. In addition, relative to SSRI users, SNRI users had significantly higher AL levels. However, there were no interactions effects between birth-assigned sex and antidepressant types on AL. We discuss the potential clinical implications of our findings, as well as directions for future studies that aim to investigate AL among male and female patients using antidepressants.