Antidepressant Use and Diabetes Mellitus Risk: A Meta-Analysis

Abstract

BackgroundEpidemiologic studies have reported inconsistent findings regarding the association between the use of antidepressants and type 2 diabetes mellitus (DM) risk. We performed a meta-analysis to systematically assess the association between antidepressants and type 2 DM risk.MethodsWe searched MEDLINE (PubMed), EMBASE, and the Cochrane Library (through Dec 31, 2011), including references of qualifying articles. Studies concerning the use of tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), or other antidepressants and the associated risk of diabetes mellitus were included.ResultsOut of 2,934 screened articles, 3 case-control studies, 9 cohort studies, and no clinical trials were included in the final analyses. When all studies were pooled, use of antidepressants was significantly associated with an increased risk of DM in a random effect model (relative risk [RR], 1.49; 95% confidence interval [CI], 1.29 to 1.71). In subgroup analyses, the risk of DM increased among both SSRI users (RR, 1.35; 95% CI, 1.15 to 1.58) and TCA users (RR, 1.57; 95% CI, 1.26 to 1.96). The subgroup analyses were consistent with overall results regardless of study type, information source, country, duration of medication, or study quality. The subgroup results considering body weight, depression severity, and physical activity also showed a positive association (RR, 1.14; 95% CI, 1.01 to 1.28). A publication bias was observed in the selected studies (Egger's test, P for bias = 0.09).ConclusionOur results suggest that the use of antidepressants is associated with an increased risk of DM.

Metabolic risk in depression and treatment with selective serotonin reuptake inhibitors: are the metabolic syndrome and an increase in cardiovascular risk unavoidable?

“…In summary, although SSRIs as a drug class are typically believed to increase the risk of DM2 [82] , current clinical evidence supports this notion predominantly for fluvoxamine and paroxetine [75] . This underlines the importance of pondering the metabolic profiles for each individual SSRI, especially in subjects with risk factors for DM2 or CVD.…”

Brain Signaling Systems in the Type 2 Diabetes and Metabolic Syndrome: Promising Target to Treat and Prevent These Diseases

“…On the other hand, there are clinical data showing that chronic administration of SSRI into nondiabetic patients can lead to insulin resistance and lipid metabolism disorders [268,269]. These data may be explained by the fact that a long-term increase of brain serotonin level above norm induces hyperactivation of serotonin signaling, resulting in the abnormalities of feeding behavior, energy expenditure and insulin sensitivity, and, in addition, leads to the changes in the circadian rhythm.…”

Cardiovascular risk factors in elderly : With special emphasis on atrial fibrillation, hypertension and diabetes

“…Treatment decisions are therefore often based on data from younger adults [112]. Antidepressants have been reported to affect glycaemic control and to trigger the onset of type 2 DM [115][116][117][118][119]. It is difficult to differentiate between the possible diabetogenic side effects of antidepressants per se (such as weight gain), from the effects associated with the depressive disorder [116,119].…”

“…Antidepressants have been reported to affect glycaemic control and to trigger the onset of type 2 DM [115][116][117][118][119]. It is difficult to differentiate between the possible diabetogenic side effects of antidepressants per se (such as weight gain), from the effects associated with the depressive disorder [116,119]. SSRIs have been reported to confer a glucose lowering effect [117,120] and animal model studies have reported glucose increment from TCAs [121].…”