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Adipositas - Ursachen, Folgeerkrankungen, Therapie 2020; 14(03): 133-139
DOI: 10.1055/a-1207-8003
Review

Gewichtsänderung als unerwünschte Arzneimittelwirkung

Weight Change as Unwanted Drug Reaction
Marcus May
1   Clinical Research Center, Medizinische Hochschule Hannover
,
Stefan Engeli∗
2   Institut für Klinische Pharmakologie, Medizinische Hochschule Hannover
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Zusammenfassung

Ziel Gewichtsänderungen als ungewollte Folge der Arzneimitteltherapie sind nicht ungewöhnlich, werden aber oft übersehen oder ignoriert oder – mangels therapeutischer Alternativen – in Kauf genommen.

Methodik Selektive Literatursuche.

Ergebnisse Zu den wichtigsten Arzneimitteln, die zu ungewolltem Gewichtsverlust führen, gehören Bupropion, Fluoxetin, Topiramat, Zonisamid und die Antidementiva Donepezil, Rivastigmin und Galantamin. Zu den wichtigsten Arzneimitteln, die zu ungewollter Gewichtszunahme führen, gehören verschiedene Neuroleptika und Antidepressiva, außerdem Insuline, Sulfonylharnstoffe und manche Immunsuppressiva.

Schlussfolgerungen Die Beurteilung ungewollter Gewichtsänderungen durch Arzneimittel hängt von einer Vielzahl von Faktoren ab, die in Studien oft nicht berichtet und erst recht nicht kontrolliert werden. Dies bedingt eine insgesamt schlechte Evidenzlage. Der Umgang mit unerwünschten Gewichtsänderungen durch Arzneimittel erfordert umfassende klinische und therapeutische Kenntnisse, um prophylaktisch agieren oder eine sinnvolle Therapieumstellung vornehmen zu können.

Abstract

Purpose Weight changes as unwanted reaction to drug treatment are not uncommon. Neglect, ignorance or acceptance due to missing therapeutic alternatives are common in clinical care.

Methods Selective literature search.

Results The most important drugs leading to unwanted weight loss are bupropion, fluoxetine, topiramate, zonisamid and the cholinesterase inhibitors donepezil, rivastigmine and galantamine. The most important drugs leading to unwanted weight gain are certain neuroleptic and antidepressive drugs, also insulins, sulfonyl urea drugs, and some immune suppressive drugs.

Conclusion The analysis of unwanted weight changes through drug treatment depends on several factors that are not reported regularly and even less so controlled in clinical studies. The result is a weak basis of evidence. Handling of unwanted weight changes through drug treatment requires a broad clinical and therapeutic knowledge to enable physicians and therapists to provide prophylactic counselling or to decide on meaningful therapeutic changes.

Schlüsselwörter

Arzneimitteltherapie - unerwünschte Arzneimittelwirkung - Gewichtszunahme - Gewichtsabnahme

Key words

drug treatment - unwanted drug reactions - weight gain - weight loss


Publication History

Article published online:
04 September 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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