The results of follow-up after type 2 diabetes onset are shown in Tables 3 and 4 and in Supplementary Fig. Cross-sectional studies have not demonstrated an increase in diabetes prevalence, independent from depressive symptoms; however, there are changes in metabolic and body composition measurements that are associated with diabetes. The presence of other conditions was defined as diagnoses in medical claims data. Most participants were white European men. Type 2 diabetes onset occurred in 5,225 individuals (5.8%): 1,950 (170,246.7 person-years) in the exposure group and 3,275 (407,875.1 person-years) in the nonexposure group. Most studies involved small numbers and were of short duration. The other 298 were followed up. Photo: Andreas Neumann. Complicating things, though, is the speculation that certain antidepressants affect blood glucose regardless of weight gain. Antidepressants were grouped as tricyclic antidepressants (TCAs), tetracyclic antidepressants (TTAs), SSRIs, serotonin and norepinephrine reuptake inhibitors (SNRIs), and others (mirtazapine, sulpiride, and trazodone). The association was seen with tricyclic antidepressants (HR 1.759 [95% CI 1.5172.040]), serotoninnorepinephrine reuptake inhibitors (HR 1.566 [95% CI 1.3511.816]), SSRIs (HR 1.481 [95% CI 1.3181.665]), and other antidepressants (HR 1.376 [95% CI 1.1981.581]). Would you like email updates of new search results? Four cross-sectional studies have examined the association between antidepressant use and the risk of diabetes. M.E. The noradrenergic nortriptyline and selective serotonin reuptake inhibitors (SSRIs) have been reported to worsen glycemic control in people with diabetes (3,4) whereas tricyclic antidepressants induce hyperglycemia in humans (5) and hyperinsulinemia in mice (6). NCI CPTC Antibody Characterization Program. This study had a small sample size, and therefore the results cannot be generalized. The study populations were variable, with participant numbers being small in most studies (n = 6, 12, 13, 16, 33, 43, 48, 59, 143, 422 and 449 participants) and poorly defined baseline risk factors. Expert Opin Drug Saf. He says doctors prescribing antidepressants should be aware of this raised risk for diabetes and ensure they monitor patients for the condition, as well as take steps to reduce the risk by encouraging changes to lifestyle. sharing sensitive information, make sure youre on a federal There was no association for those with depression who were not using antidepressants (HR 1.10; 95% CI 0.851.43; P = 0.47). The medical claims and health check data were initially provided by main employee health insurance associations in Japan to JMDC, which linked and anonymized the data using identifiers before providing them to the National Center of Neurology and Psychiatry. Are There Any Safe Antipsychotics in Diabetes Treatment? Inclusion criteria were 1) age 2079 years and 2) information available for prescriptions and health check results during the 12-month period before and the 12-month period after cohort entry. This was a retrospective cohort study in which we used linked anonymized data from medical claims and health checks for 3,382,567 employees and their family members, aged 2079 years, who were insured by the five main employee health insurance associations in Japan; the data were provided by JMDC Inc. (Tokyo, Japan). Second, the study population was employees and their family members insured by employee health insurance associations; therefore, not many children and elderly individuals were included. Health and Labor Sciences Research grants for comprehensive research for persons with disabilities, FY2015 comprehensive report and division reports [in Japanese]. Study design variability prevents meaningful meta-analyses. BMI categories were underweight/normal (<25.0 kg/m2), overweight (25.029.9 kg/m2), and obese (30.0 kg/m2). Heightened alertness to potential risks is necessary until these are complete. All rights reserved. Continuous antidepressant use was also significantly associated with diabetes risk in the PLB (HR 2.60 [95% CI 1.374.94] and ILS arms (HR 3.39 [95% CI 1.617.13]). A case-control study in Taiwan showed that antidepressant use for 2 years increased the risk of type 2 diabetes (12), but such an association has not yet been investigated in Japan. The cumulative incidence of self-reported diabetes was 6.7%, with an 8.6% rate in women with elevated depressive symptoms. The Tukey-Kramer multiple comparison test showed significant differences between the continuation and discontinuation groups and between the continuation and dose reduction groups at years 1, 2, and 3 after onset. Further studies with larger sample sizes are needed. Overall, antidepressants may help normalize sleep over time. The selective serotonin reuptake inhibitor fluoxetine has direct effects on beta cells, promoting insulin secretion and increasing beta-cell mass. K.B. being able to get an erection, but not having it last long enough for sex. Research designs included 1 case series and 21 observational studies comprising 4 cross-sectional, 5 case-control, and 12 cohort studies. Antidepressants are widely prescribed in developed countries (1). Antidepressant use was increased in the 4 years before and in the 4 years after diabetes diagnosis, although there was a temporary peak in antidepressant use during the year of the diabetes diagnosis (OR 2.66 [95% CI 1.943.65]. Rates of diabetes and components of the metabolic syndrome were examined in 461 people from the Hordaland Health Survey, Norway, taking SSRIs and compared with 25,315 participants not taking antidepressants (14). Diabetes Care 1 April 2020; 43 (4): 885893. Recent concerns that antidepressants may adversely affect glucose metabolism require investigation. Researchers say people with type 2 diabetes who exercise in the afternoon seem to have better results in controlling blood glucose levels. and R.I.G.H. Is the ketogenic diet right for autoimmune conditions? Low self-esteem, feelings of hopelessness and physical fatigue can lower your libido (sex drive). Generic Viagra (sildenafil) is an alternative to the branded Viagra drug that can be used for treating erectile dysfunction (ED). Unauthorized use of these marks is strictly prohibited. Data are n (%) unless otherwise indicated. H.T. They note that although study quality was variable, the more recent, larger studies suggest a modest effect. K.B. Its possible that without the weight gain, antidepressants wouldnt be a potential cause of diabetes. The following lists arent exhaustive, as there are other classes of antidepressants and numerous other individual medications, but they do highlight many antidepressants researched thus far and discovered to impact diabetes. Others have mixed results, sometimes worsening and sometimes improving depression. The population-based cross-sectional 2005 and 2007 National Health and Nutrition Examination Studies explored the association between clinically identified and undiagnosed prediabetes and type 2 diabetes with depression and antidepressants (15). In conclusion, from the evidence reviewed, there is a link between antidepressant use and diabetes, but causality is not established. HbA1c levels returned to the normal range in 97.5% of patients (79 of 81) in the discontinuation group and in 94.0% (63 of 67) in the dose reduction group; the difference was not significant. Currently, the only CBD product approved by the Food and Drug Administration is a prescription oil called Epidiolex. Please enable it to take advantage of the complete set of features! dizziness. Antidepressant use was only increased 2 months before and 3 months after initiation of diabetes treatment, with the marked increase in the incidence of antidepressant use in the month after initiation of diabetes treatment, with incidence rate ratio of 2.4 (95% CI 2.03.0). Medical claims data do not explain why physicians continued prescribing the same antidepressants; however, physicians might not suspect the association between antidepressants and type 2 diabetes onset or might underestimate the effect of antidepressants. Weight Gain. Cognitive behavioral and selective serotonin reuptake inhibitor (SSRI) treatment may improve glycemic control in depressed DM2 patients, whereas noradrenergic antidepressants and tricyclic antidepressants (TCAs) may cause the metabolic situation to deteriorate. trustworthy health information: verify Long-term antidepressant use increased the risk of type 2 diabetes onset in a time- and dose-dependent manner. Intermittent antidepressant use was only associated with increased diabetes risk in the ILS arm (HR 2.07 [95% CI 1.183.62]). 5 In fact, most people who take an SSRI experience genital sensory changes within 30 minutes of taking the drug. Thus, nine categories were derived on the basis of the combination of the prescription duration and the mean monthly dose. undertook the quality analysis and wrote the first draft. Antidepressant use was self-reported in 94 individuals (1.6%) at baseline, and overall, 419 (7.0%) reported using antidepressants at some point in the study. Mixed-effects modeling compared differences in continuous variables, such as weight, by antidepressant use or depression symptoms. The mixed effects of antidepressants lead to more questions. Although evidence exists that antidepressant use may be an independent risk factor for type 2 diabetes, long-term prospective studies of the effects of individual antidepressants rather than class effects are required. Among 52,326 women, in a study led by the Womans Health Initiative, antidepressant use was associated with increased risk of new-onset diabetes after adjustment for depressive symptoms, BMI, age, ethnicity, education, physical activity, smoking status, and family history of diabetes (HR 1.32; 95% CI 1.191.47) (27). The proportion of patients who switched medications during this follow-up period was small (1% of all patients), and they were excluded. More information is available at, This site uses cookies. The durations of exposure and nonexposure were defined as the number of months when an antidepressant was prescribed and not prescribed, respectively. Glucose control refers to the bodys ability to keep blood sugar levels within a healthy range, neither climbing too high nor dropping too low. The number of men receiving antidepressants (n = 365) was much lower than women (n = 12,747). After multivariate adjustment, the concurrent use of SSRIs and tricyclic antidepressants was associated with a significantly increased risk of type 2 diabetes compared with the use of tricyclic antidepressants alone (adjusted OR 1.89 [95% CI 1.352.65]). 1 However, there are potential long-term effects of antidepressants on the brain and body, which may . The study was conceived and designed by all authors. (32) examined short- and long-term effects of duloxetine (20120 mg/day) on glycemic control in patients with diagnoses other than diabetic peripheral neuropathic pain. No increased incidence of diabetes in antidepressant users, Glucose metabolism and antidepressant medication, The effect of antidepressants on glucose homeostasis and insulin sensitivity: synthesis and mechanisms, Duloxetine treatment and glycemic controls in patients with diagnoses other than diabetic peripheral neuropathic pain: a meta-analysis, Association between antipsychotic drugs and diabetes, The environment and disease: association or causation. Combination therapies of two or more antidepressants also showed a significant association with type 2 diabetes risk, although 95% CIs were large for some antidepressant combinations, owing to the small sample size. Our research shows that when you take away all the classic risk factors of type 2 diabetes; weight gain, lifestyle etc, there is something about antidepressants that appears to be an independent risk factor.. Numerous studies have uncovered three connections: Many antidepressants cause significant weight gain ("Antidepressants and Weight Gain SSRIs and Weight Gain"). Antidepressant use was examined in 49,593 people with diabetes and a random sample of 154,441 people without diabetes included in a pharmacy database in the Netherlands (17). K.B., R.C.P., and R.I.G.H. MeSH Depressive symptoms were assessed with CES-D. A strong association between baseline antidepressant use and incident physician-diagnosed diabetes was observed (adjusted OR 3.10 [95% CI 1.665.78]), but there was no association with incident study screen-detected diabetes (adjusted OR 1.24 [95% CI 0.542.87], P = 0.62) with no sex differences. Increased antidepressant use is occurring concurrently with increasing diabetes prevalence; thus, any cause-and-effect interpretation does not conflict with generally known facts of the natural history and biology of the disease. Thus different classes of antidepressants may induce hyperglycemia through distinct pathways and have different diabetes-related risks. This review is an overview on antidepressant treatment and its potential metabolic risks. Eating healthy and exercising are crucial, too, and will go a long way in improving both depression and diabetes. For someone with diabetes, blood sugar levels should be 180 mg/dL or less. 2008 Apr;17(4):336-44. doi: 10.1002/pds.1562. Our results suggest that reducing the dose of or discontinuing causative antidepressants within 1 year of type 2 diabetes onset alleviates impaired glucose tolerance, which in turn strongly suggests a causal relationship between antidepressant administration and type 2 diabetes onset. Among those who developed type 2 diabetes while they were receiving antidepressant therapy, 10.2% (199 of 1,950) did not take antidiabetes drugs and continued the same antidepressant therapy. Missing data for lifestyle items (i.e., alcohol intake, smoking status, exercise habits, and late-evening snacking) were replaced by using multiple imputations. Although this occurs in the case histories, cohort, and experimental studies, in other studies, diabetes preceded antidepressant use, with evidence of reverse causality. The relationship among antidepressant use, glucose levels, and diabetes status was explored in 5,978 civil servants in the Whitehall II study during an 18-year period (28). Could it be possible that the type of antidepressant taken for depression makes a difference? The symptoms and severity of depression vary from person to person. This review has found evidence that some antidepressants affect glucose metabolism and that antidepressant use may be an independent risk factor for diabetes. Hiroyuki Miidera, Minori Enomoto, Shingo Kitamura, Hisateru Tachimori, Kazuo Mishima; Association Between the Use of Antidepressants and the Risk of Type 2 Diabetes: A Large, Population-Based Cohort Study in Japan. April 9, 2009 Taking moderate to high daily doses of antidepressants for more than 2 years is associated with an 84% increased risk for diabetes, according to a large observational study. The heterogeneity of included populations may well have obscured any effect of antidepressants on glucose metabolism. Can diet help improve depression symptoms? "Vitamn C njdete v ovoc, ako s pomarane a jahody, a vitamn E v . Available from, Type of antidepressant therapy and risk of type 2 diabetes in people with depression, Long-term use of antidepressants for depressive disorders and the risk of diabetes mellitus, No increased incidence of diabetes in antidepressant users, Diabetes incidence associated with depression and antidepressants in the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA), An epidemiologic study of psychotropic medication and obesity-related chronic illnesses in older psychiatric patients, Antidepressant use, depression, and new-onset diabetes among elderly Medicare beneficiaries, The prevalence of comorbid depression in adults with diabetes: a meta-analysis, Depression and type 2 diabetes over the lifespan: a meta-analysis, Antidepressant medication use, weight gain, and risk of type 2 diabetes: a population-based study, Long-term antidepressant use and the risk of type 2 diabetes mellitus: a population-based, nested case-control study in Taiwan, Correlation among fasting plasma glucose, two-hour plasma glucose levels in OGTT and HbA1c, Use of antidepressant medication and risk of type 2 diabetes: results from three cohorts of US adults, Frequency of new-onset diabetes mellitus and use of antipsychotic drugs among Central Texas veterans, The central role of the propensity score in observational studies for causal effects, Statistical Power Analysis for the Behavioral Sciences, Constructing a control group using multivariate matched sampling methods that incorporate the propensity score, Optimal caliper widths for propensity-score matching when estimating differences in means and differences in proportions in observational studies, Antidepressants and body weight: a comprehensive review and meta-analysis, The tricyclic antidepressant clomipramine increases plasma glucose levels of mice, Selective serotonin reuptake inhibitors (SSRIs) inhibit insulin secretion and action in pancreatic cells, Selective serotonin reuptake inhibitors fluoxetine and fluvoxamine induce hyperglycemia by different mechanisms, Depressive symptoms, antidepressant use, and the incidence of diabetes in the Black Womens Health Study, Diabetes Prevention Program Research Group, Elevated depression symptoms, antidepressant medicine use, and risk of developing diabetes during the diabetes prevention program, Marginal structural models for the estimation of the risk of diabetes mellitus in the presence of elevated depressive symptoms and antidepressant medication use in the Womens Health Initiative observational and clinical trial cohorts, Tables regarding the notified status of employment of foreign workers [in Japanese] [Internet], Depressive disorder and incident diabetes mellitus: the effect of characteristics of depression, Antidepressant medication use and risk of hyperglycemia and diabetes mellitus: a noncausal association, Use of antidepressants and statins and short-term risk of new-onset diabetes among high risk adults, Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants [published correction appears in Lancet 2017;389:e2], Long-term complications of diabetes mellitus, Geriatrics Working Group of the Italian Medicines Agency, High prevalence of poor quality drug prescribing in older individuals: a nationwide report from the Italian Medicines Agency (AIFA). These include: sertraline (brand name . The increased risk did not appear confounded by indication, because elevated depression scores were not associated with increased diabetes risk. undertook the literature search. When depression improves, people are more likely to eat nutritiously, exercise, take necessary medications (especially for diabetes), and monitor their blood glucose levels. Whether its via weight gain or direct effect, antidepressants often inhibit glucose control. Therefore, further studies are needed to assess whether there are differences in vulnerability to antidepressant-induced diabetes among ethnicities and to identify which classes of antidepressants are associated with diabetes risk. designed the study and interpreted the data. Can diet and exercise reverse prediabetes? No language restrictions were applied. 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