Plasma insulin levels are increased by sertraline in rats under oral glucose overload

Abstract

Recognition and control of depression symptoms are important to increase patient compliance with treatment and to improve the quality of life of diabetic patients. Clinical studies indicate that selective serotonin reuptake inhibitors (SSRI) are better antidepressants for diabetic patients than other drugs. However, preclinical trials have demonstrated that not all SSRI reduce plasma glucose levels. In fact, fluoxetine increases and sertraline decreases glycemia in diabetic and non-diabetic rats. In the present study we evaluated plasma insulin levels during fasting and after glucose overload after treatment with sertraline. Adult male Wistar rats were fasted and treated with saline or 30 mg/kg sertraline and submitted or not to glucose overload (N = 10). Blood was collected and plasma insulin was measured. The mean insulin levels were: fasting group: 25.9 ± 3.86, sertraline + fasting group: 31.10 ± 2.48, overload group: 34.1 ± 3.40, and overload + sertraline group: 43.73 ± 5.14 µU/ml. Insulinemia was significantly increased in the overload + sertraline group. There were no differences between the other groups. No difference in glucose/insulin ratios could be detected between groups. The overload + sertraline group was the only one in which a significant number of individuals exceeded the upper confidence limit of insulin levels. This study demonstrates that sertraline increases glucose-stimulated insulin secretion without any change in peripheral insulin sensitivity.

Serotonin enhances β-endorphin secretion to lower plasma glucose in streptozotocin-induced diabetic rats

“…Evidence of insulin-dependent hypoglycemic effect of serotonin (Yamada et al, 1989;Sugimoto et al, 1990), SSRIs, or monoamine oxidase inhibitors (Lundquist et al, 1971;Furman, 1974;Smith and Pogson, 1977;Wilson and Furman, 1982;Gomez et al, 2001;Pollak et al, 2001) has been provided in many previous studies. Not all of the SSRIs lowered the plasma glucose in association with the increase of plasma insulin level (Erenmemisoglu et al, 1999).…”

“…The hypoglycemic activities of these substances are enhanced in mice pretreated with monoamine oxidase inhibitor (Lundquist et al, 1971;Furman, 1974;Smith and Pogson, 1977;Wilson and Furman, 1982). The selective 5-HT reuptake inhibitors (SSRIs, such as fluoxetine and sertraline) can reduce plasma glucose, while the plasma level of insulin was found to be increased (Yamada et al, 1989;Gomez et al, 2001) or to be unaltered (Erenmemisoglu et al, 1999). The exact mechanism by which SSRI or 5-HT agonists mediate hypoglycemic effect remains unclear.…”

Depression and the Adolescent with Type 1 Diabetes: The Covert Comorbidity

“…However, it is more difficult to find information regarding those adolescents who have been diagnosed with Type 2 diabetes, which has recently become an increasing phenomenon. Fortunately, there are accepted therapies for the treatment of depression in patients with diabetes (Gomez et al, 2001;Kassiou & Tsamasiros, 1999;Katon et al, 2003;Lloyd & Brown, 2002). There is a continued need for more practitioners who are informed in both medical and psychiatric treatments so that appropriate referrals can be made.…”

“…Sawka, Burgart and Zimmerman (2001) found that some antidepressant medications have been associated with lack of hypoglycemia awareness. Selective Serotonin Reuptake Inhibitors (SSRIs) have been shown to be better antidepressant choices than tricyclic antidepressants for diabetic patients (Gomez, Huber, Lhullier, & Barros, 2001). Tricyclic antidepressants can increase appetite leading to decreased blood glucose control (Jacobson, 1996).…”

Amitriptyline and Sertraline in Diabetic Neuropathy: A Comparative View

“…Nevertheless, TCA, SSRI and AED are only mainly useful in relieving the pain of neuropathy 9,10 . Sertaline, amitriptyline and anticonvulsant drugs are used in the treatment of diabetic neuropathy but they all have side effects.…”