Antidepressants linked to higher risk of type 2 diabetes

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Main Category: Diabetes
Also Included In: Depression;  Mental Health;  Psychology / Psychiatry
Article Date: 25 Sep 2013 – 8:00 PDT

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A new systematic review of published studies suggests when prescribing antidepressant medication, clinicians
should be extra aware that they are linked to raised risk for type 2 diabetes, although the study does not suggest the
drugs are the direct cause.

Reporting their findings in the latest issue of Diabetes Care, researchers from the University of
Southampton say use of antidepressants has risen sharply over recent years, and there are concerns they may have an
adverse effect on glucose metabolism.

They note 46.7 million prescriptions for antidepressants were issued in 2011 in the UK.

Antidepressant use has also soared in the US, where a
2011 study found they are now the third most widely prescribed group of drugs.

Several studies have shown that antidepressant use is linked to diabetes, but the results have been varied,
depending on the methods and numbers involved and also on the types of drugs themselves.

For instance, one study that found a link between antidepressants and risk for type 2 diabetes discovered
the risk almost doubled in patients using two types of drugs at the same time: tricyclic antidepressants (TCAs) and
selective serotonin reuptake inhibitors (SSRIs).

Antidepressant users more likely to have type 2 diabetes

Injection
Researchers found a link between people who take antidepressants and type 2 diabetes, although it does not mean there is a direct causal effect.

For their systematic review, Southampton health psychologist Dr. Katharine Barnard and colleagues assessed 22 studies
and three previous reviews that looked at the link between antidepressant use and risk for type 2 diabetes.

They found that overall, people on antidepressants were more likely to have type 2 diabetes.

Within that, however, the picture is somewhat “confused, with some antidepressants linked to worsening glucose control, particularly with
higher doses and longer duration, others linked with improved control, and yet more with mixed results.”

They note that although study quality was variable, the more recent, larger studies suggest a modest
effect.

The researchers also propose that different types of antidepressants may be linked to different amounts of risk and
call for long-term randomized, controlled trials to examine the effects of individual drugs.

Several ‘plausible’ explanations

While their review was not designed to investigate causes, the team says there could be several plausible
explanations for the link. For instance, some antidepressants cause patients to put on weight, which in itself increases risk for type 2
diabetes.

But they also point out that some of the studies they reviewed found the raised risk for type 2 diabetes persisted
when they took out the effect of weight gain, suggesting other factors could be involved.

Dr. Barnard says:

“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.”

She says that in light of rising prescriptions, “this potential increased risk is worrying,” and:

“Heightened alertness to the possibility of diabetes in people taking antidepressants is necessary until further
research is conducted.”

Co-author Richard Holt, professor in Diabetes and Endocrinology at Southampton, adds:

“While depression is an important clinical problem and antidepressants are effective treatments for this
debilitating condition, clinicians need to be aware of the potential risk of diabetes, particularly when using
antidepressants in higher doses or for longer duration.”

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.

Written by Catharine Paddock PhD

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

  • Additional
  • References
  • Citations

Antidepressant Medication as a Risk Factor for Type 2 Diabetes and Impaired Glucose Regulation; Katharine Barnard,

Robert C. Peveler, and Richard I.G. Holt; Diabetes Care October 2013 vol. 36 no. 10 3337-3345;

DOI:10.2337/dc13-0560;
Abstract.

Additional source: University of Southampton news release via EurekAlert 24 September 2013.

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Visitor Opinions (latest shown first)

Could be a case of correlation not equaling causation

posted by Justin on 25 Sep 2013 at 11:57 am

Diabetes patients have a higher risk of suffering from depression (both type 1 and type 2). The lifestyles of some patients with type 2 diabetes are often linked to depression (overweight, types of foods eaten, etc).

The extra weight gain as a side effect of the drugs is quite relevant though. I’m not saying that these drugs don’t contribute to type 2 diabetes risk, but there are many other factors in play here.

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Control for antidepressant effect on mood

posted by Otis on 25 Sep 2013 at 11:26 am

I’m curious if there is a difference in diabetes risk among those taking antidepressants with their depression alleviated and those taking antidepressants without their depression alleviated.

I apologize as I don’t have the citation (I think the paper is still in review) and I am stating this based upon personal conversation with the researchers, but antidepressant’s improvement on the rate of myocardial infarction was found to be none on a recent large review. When the researchers looked at the data for antidepressant effectiveness, they found that antidepressant use that alleviated depression did indeed reduce the rate of myocardial infarction.

Antidepressants are widely used, but they are not universally effective. The need for care providers and patients to know the risks and benefits of the drugs is obviously important. I think it is just as important to know what the risks and benefits are when the drugs do and don’t work.

For example, I am planning a pregnancy with a mood disorder. I know my drugs work, and I don’t want to change my treatment if the alternatives have the same or worse outcomes when effective as I am gambling with the possibility that the alternatives won’t work for me. Unfortunately, there is any data to compare the outcomes of my drugs with alternatives during pregnancy based upon whether they successfully manage the mood.

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MNT (logo) is the registered trade mark of MediLexicon Int. Limited.