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(Health Rounds is published Tuesdays and Thursdays. Think your friend or colleague should know about us? Forward this newsletter to them. They can also subscribe here .) by Nancy Lapid
Hello Health Rounds readers! Antidepressants have long been linked to weight gain, but now a study finds there’s little difference between a wide variety of medications. We also cover a study that suggests shingles vaccines may protect the heart, as well as a potential breakthrough to improve screening for sleep disorders.
Health Rounds will be away for the July 4th holiday in the United States and will return next week with important medical studies and advances.
Weight gain due to antidepressants varies only slightly
Weight gain after starting antidepressant treatment is not likely to vary much depending on the drug, according to a report published Monday in the Annals of Internal Medicine.
Of the eight antidepressants studied, bupropion (Wellbutrin) was consistently associated with the least weight gain, the researchers said.
However, only small differences in weight changes were likely among patients taking either drug, they said.
Researchers mimicked a randomized trial to compare the drugs using medical records from more than 183,000 adults who began treatment with bupropion, sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), venlafaxine (Effexor), paroxetine (Paxil), or duloxetine (Cymbalta).
Zoloft – the most commonly prescribed first-line drug, used by 20% of participants – was associated with an average gain of nearly 0.5 pounds (0.2 kilograms) after six months.
Users of Lexapro, Paxil, and Cymbalta gained an average of 0.7 to 0.9 pounds (0.3 to 0.4 kilograms) more than those taking Zoloft after 6 months, and were 10 to 15 percent more likely to have gained at least 5 percent of their starting weight.
Wellbutrin users gained about a half-pound less on average than Zoloft users, and they were 15% less likely to gain at least 5% of their baseline weight.
The effect of Prozac on weight change was similar to that of Zoloft.
“Clinicians and patients might consider these differences when making decisions about specific antidepressants, particularly given the complex relationships of obesity and depression with health, quality of life, and stigma,” the researchers said.
Shingles vaccine linked to cardiovascular benefits
A new study suggests that shingles vaccines may have the added benefit of protecting against strokes and heart attacks.
The researchers compared 27,093 adults who had been vaccinated against the herpes zoster virus with five times as many similar people who had not been vaccinated. Over the five years of follow-up, stroke rates were 1.6% among those who had been vaccinated, compared with 2.2% among those who had not received the shingles vaccine. Heart attack rates were 1.3% and 1.8%, respectively.
The study was not a randomized trial and therefore cannot prove that the vaccine actually prevented cardiovascular events.
All study participants had received the first shingles vaccine, Zostavax from Merck & Co MRK.N , which is no longer marketed in the United States.
Shingrix, the currently available vaccine from GSK GSK.L , is superior to the first vaccine in preventing shingles and is recommended in the United States for all adults aged 50 and older and for younger adults who are or will be at increased risk of shingles due to immunodeficiency or immunosuppression, the authors note in a report published in the American Journal of Preventive Medicine .
The benefits of Merck’s older vaccine in reducing the risk of stroke and heart attack were greatest in people with diabetes, but patients with other conditions, including high blood pressure, chronic obstructive pulmonary disease, high cholesterol or obesity, also saw reduced risk, the researchers found.
The researchers called for similar studies on Shingrix’s effect on heart attacks and strokes, but added that the findings may be relevant in parts of the world where Zostavax remains available.
Sleep monitoring using a single ECG lead
Artificial intelligence combined with a single electrocardiography probe could eventually replace the multiple annoying wires on the head and chest currently used to diagnose sleep disorders, researchers say.
“Our method achieves expert-level agreement with gold-standard polysomnography without the need for expensive, bulky equipment and a clinician to score the test,” study leader Bhavin Sheth of the University of Houston said in a statement.
“This advancement paves the way for more accessible and cost-effective sleep studies,” Sheth added.
The electrocardiography-based AI model was trained on data from 3,000 children and adults and then tested on data from an additional 1,000 participants, according to a report published in Computers in Biology and Medicine.
Previously, sleep monitoring methods that did not include brain monitoring using electroencephalography had yielded “suboptimal” results, suggesting that EEG would still be necessary, the researchers said.
The new results challenge this idea, they add.
“Our results establish that automated sleep staging based on electrocardiography – or cardiosomnography – “can achieve performances comparable to those of polysomnography,” they conclude.
