Antidepressants may raise diabetes risk

People taking antidepressants are at a higher risk of type 2 diabetes, a new study has warned.

A number of studies have been carried out to establish whether antidepressants are linked with diabetes but results have varied depending on the methods used, type of medication and the number of participants.

In a systematic review, researchers at the University of Southampton found that people taking antidepressants are at a higher risk of type 2 diabetes.

However, the study cautioned that it is not certain whether the medication is responsible for the condition.

Researchers assessed 22 studies and three previous systematic reviews that looked into the effects of antidepressants on diabetes risk. Overall, people taking antidepressants were more likely to have diabetes.

However, the researchers warned that different types of antidepressants may carry different risks and long-term prospective randomised control trials are needed to look at the effects of individual tablets.

The team said that there are “several plausible” reasons why antidepressants are associated with an increased risk of diabetes.

For example, several antidepressants are associated with significant weight gain which increases the risk of type 2 diabetes.

However, they also said that several studies which explored this association still observed an increased risk of diabetes after adjustment for changes in body weight, implying other factors could be involved.

“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,” said Dr Katharine Barnard, Health Psychologist from the University of Southampton.

“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,” said Richard Holt, Professor in Diabetes and Endocrinology at the University.

Antidepressants linked to higher risk of type 2 diabetes

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Academic Journal
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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Happy pills are linked to a higher risk of diabetes: Antidepressants can cause …

  • Researchers say the risk is for all antidepressants, not just some types
  • The pills could put hundreds of thousands at risk of type 2 diabetes
  • The increased risk could be because people on antidepressants are more likely to be overweight and this is a risk factor for diabetes
  • Scientists think the pills may also be an independent risk factor

By
Sophie Borland Health Reporter

14:00 EST, 24 September 2013


|

19:10 EST, 24 September 2013

Antidepressants taken by hundreds of thousands of people may increase the chances of developing diabetes, researchers warn

Antidepressants taken by hundreds of thousands of people may increase the chances of developing diabetes, researchers warn

Antidepressants taken by hundreds of thousands of people may increase the chances of developing diabetes, researchers warn.

A major study involving more than a million patients has shown that those taking all antidepressant pills are at far higher risk from the condition.

Academics from Southampton University think this may be because antidepressants cause weight gain which in turn leads to type 2 diabetes.

But despite the strong link, they cannot be sure that the pills are definitely causing the condition.

Patients on antidepressants are more likely to be overweight so have a higher risk of developing diabetes in the first place than healthy individuals.

The numbers of Britons taking antidepressants has soared in the last decade and more than 50 million prescriptions were handed out by GPs last year compared to just 20 million in 1999.

But experts say doctors are handing out the pills too freely without considering the possible long-term side effects.

In one of the largest studies of its kind, academics from Southampton University looked at 25 research papers that involved just over a million patients.

The study, published in the journal Diabetes Care, found many patients were developing type 2 diabetes – the commonest form – after they had been prescribed antidepressants, which suggests the pills cause the illness.

Antidepressants can cause weight gain
and obesity which in turn worsens the body’s ability to regulate blood
sugar -which triggers diabetes.

Lead researcher Dr Katharine Barnard, a
health psychologist from the University of Southampton said:
‘Antidepressants are used widely in the UK, with a significant increase
in their use recently.

A major study involving more than a million patients has shown that those taking all antidepressant pills are at far higher risk from the condition

A major study involving more than a million patients has shown that those taking all antidepressant pills are at far higher risk from diabetes

‘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.

‘This potential increased risk is worrying. Heightened alertness to the possibility of diabetes in people taking antidepressants is necessary until further research is conducted.’

Richard Holt, Professor in Diabetes
and Endocrinology at the University of Southampton, said: ‘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.

‘When
prescribing antidepressants, doctors should be aware of this risk and
take steps to monitor for diabetes and reduce that risk of diabetes
through lifestyle modification.’

The numbers of Britons taking antidepressants has soared in the last decade and more than 50 million prescriptions were handed out by GPs last year compared to just 20 million in 1999

The numbers of Britons taking antidepressants has soared in the last decade and more than 50 million prescriptions were handed out by GPs last year compared to just 20 million in 1999

Around 3 million people in Britain have now been diagnosed with diabetes, nearly twice as many compared to 1996 when there were just 1.4 million sufferers.

The rise has been blamed on increasing levels of obesity and nine in ten patients have type 2 diabetes which is triggered by being overweight.

Experts calculate that by 2020, there will be 4 million people in the UK with the condition.


Comments (54)

Share what you think

The comments below have not been moderated.

Nicky,

Cheadle Hulme, United Kingdom,

9 minutes ago

I love these comments particularly as I have yet to see a GP who isn’t a loon anyway:)

dean,

Wise County Texas,

22 minutes ago

Sophie Borland, you haven’t a clue. Antidepressants do not make people happy.

It is true however that far too many people are prescribed these who may not truly need them. In the USA, doctors are pressured to give these out, and then sued if someone offs themselves while taking them.

polyxenes,

Fort Worth, United States,

1 hour ago

I’d like to see “happy pill” replaced with the accurate description “antidepressant”. As a long-term sufferer of severe depression, these medications have literally saved my life.

Yes, I have gained some weight – I am far from overweight – and diabetes runs in my family, but I consider the risks involved as opposed to quality of life.

In addition to antidepressants, I am in therapy and look forward to mental health in the future. With any medication, doctors are quick to write a prescription / apply a band-aid. Any drug can be misprescribed.

ang,

London,

2 hours ago

I wish the DM would stop calling them happy pills. for some people they just help to live a normal life not ‘happy’

swindongal,

Swindon, United Kingdom,

56 minutes ago

So true, I need them just to function and live a normal life. Without them I sleep most of the time and have no control of my moods. I’m either crying or angry.

charlatans77,

wilmslow,

3 hours ago

Someone who has reached a situation in life where they are prescribed antidepressants are going to be less likely to excerise as lack of energy and motivation are symptons of depression as is comfort eating. Also a side effect of antidepressants can be drowsiness which is also going to make the patient less active. A patient with a broken leg is probably also going to gain weight but not because of the painkillers. Simple scaremongering.

l–_–l,

Sunny Florida, United States,

3 hours ago

I took Prozac at age 27 and in less than 2 years my weight jumped from 135 to 164. The gain was so depressing! My weight went back down after discontinuing it. In the almost 18 years since then, I’ve taken 2 other antidepressants with no weight gain. At age 45, I feel fortunate to have low blood pressure, cholesterol and blood sugar.

Anne,

Glasgow,

4 hours ago

Everything and anything can cause weight gain or loss but it’s how we manage this which is important.

is the pope catholic,

rome, Vatican,

4 hours ago

so if your taking them be mindful of this and excersise and eat healthy etc,but then again,next week they will say prozac cures diabetes

JoeEsty,

Denver,

4 hours ago

And they don’t work anyway.

Nicky,

Cheadle Hulme, United Kingdom,

11 minutes ago

It depends – they do sometimes and if they don’t you need to have a chat with someone:)

Miss,

UK, United Kingdom,

5 hours ago

Developing diabetes in later life is a small price to pay for a depression treatment that actually works.

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Hugh Laurie speaks candidly about his struggle with depression

Gone are the days when this kind of mental condition was considered something to be ashamed off –the scene has changed as a majority of the population suffers from some form of depression.

Hugh Laurie, a famous British actor, writer and comedian has been struggling from acute clinical depression. Like other renowned faces Kirsten Dunst and Gwyneth Paltrow, Hugh always talked about his depression to the media because he feels that depression is not a taboo. Cinemablend.com quotes the star as saying: “I do know depression is a disease… It is the last great taboo – something people still don’t want to talk about.”

Being the victim of this depressive condition, Hugh opines that depression should be taken seriously because delayed treatment can cost you your life. There was the time when he experienced loss of emotions where he could not express his fear or excitement and suffered from this low phase. Of this time, Laurie said, “It affected everything – my family and friends. I was a pain in the arse to have around. I was miserable and self-absorbed. It’s actually selfish to be depressed and not try and do anything about it.”

Hugh Laurie devoted two long years in psychotherapy to bring about the necessary change in his life. His battle with depression started in his early teens and stretched into his successful career and happy marriage.

Hugh found a way out of depression with antidepressants. He said: “They’re something I’ve tried that has helped. They’re probably good for my work because they help with confidence, and confidence is the prerequisite of all successful endeavors.”

The love and support of his family helped Hugh Laurie to bravely face depression and owing his recovery also to them, he said: “It’s terrific, and I’m very lucky. I’m so much happier now and more accepting of things. I used to get consumed with things that were in the past. I saw a million different versions of who I could have been and all of them were better: ‘Why didn’t I do this? Why didn’t I do that?’”

Surprisingly, even though Hugh was fiercely private about his personal life with the media, he decided to spill the beans about his depression. Later regretting this decision, he told Parade Magazine: “I wish I’d kept my mouth shut about that… Now an undue weight has been given to this aspect of my life. I don’t like to be thought of as this guy who has nothing else to talk about except how miserable my lot was.”

Whether he regrets opening up about depression is not important. Far more important is that he did open up about this issue, which affects millions the world over. Sometimes it takes a celebrity to discuss their personal battles for others to realize it’s time to seek help.

Other clinically depressed celebrities include Jim CarreyJ.K. RowlingHalle Berry, Kylie Minogue and Owen Wilson.

Image: http://commons.wikimedia.org/wiki/File:Hugh_Laurie_2009.jpg;
Author: Kristin Dos Santos

What is the best antidepressant?

Depression medication (antidepressants) come in many forms and make use of different chemicals to try to restore a healthy mental balance.

Different types of antidepressants according to WebMD:

Selective serotonin reuptake inhibitors (SSRIs)
This medication alters the amount of serotonin (a chemical in the brain) produced.

Serotonin and norepinephrine reuptake inhibitors (SNRIs)
Here, serotonin and norepinephrine levels are increased.

Tricyclic antidepressants (TCAs)
These older antidepressants also affect the levels of serotonin and norepinephrine in the brain. However, they do have more side effects and are not usually a doctor’s first choice.

Monoamine oxidase inhibitors (MAOIs)
Another older type of drug, most suited to those who are not responsive to other treatment. These are not typically a doctor’s first choice either because of the strict dietary regulations which must be adherred to when taking them.

A recent study has revealed the efficacy of a number of popular antidepressant drugs versus their acceptability, ABC News reported. Efficacy stands for how successful the medication is in producing the desired effect and acceptability shows how likely the patient was to continue using the drug throughout the survey, thus highlighting the extent of undesirable side effects.

Some of the drugs tested in the study included:

Prozac, Zoloft, Celexa, Paxil, Luvox, Lexapro
All these are SSRIs with potential side effects such as sexual problems, headaches, nausea, dizziness and insomnia.

Wellbutrin
This drug aims to increase the amount of norepinephrine and dopamine in the brain. It is reportedly less likely to cause sexual problems or weight gain seen with other drugs but can give the patient insomnia, anxiety, a dry mouth and a decreased appetite.

Remeron, Effexor, Cymbalta
These SNRIs can lead to nausea, fever or chills, constipation, blurred vision as well as increased blood pressure and sweating in the case of Cymbalta.

The results showed that those rated highest for efficacy were:

1) Mirtazapine (Remeron)
2) Escitalopram (Lexapro)
3) Venlafaxine (Effexor)
4) Sertraline (Zoloft)
5) Citalopram (Celexa)
6) Buproprion (Wellbutrin)
7) Paroxetine (Paxil)
8) Milnacipran (Savella)
9) Fluoxetine (Prozac)
10) Duloxetine (Cymbalta)

And those rated highest for acceptability:

1) Sertraline (Zoloft)
2) Escitalopram (Lexapro)
3) Buproprion (Wellbutrin)
4) Citalopram (Celexa)
5) Fluoxetine (Prozac)
6) Milnacipran (Savella)
7) Mirtazapine (Remeron)
8) Venlafaxine (Effexor)
9) Paroxetine (Paxil)
10) Duloxetine (Cymbalta)

Depressed celebrities include Jim CarreyJ.K. RowlingHalle BerryHugh Laurie and Owen Wilson.

Disclaimer: We are not doctors, please consult a physician for advice on the treatment of depression.This information is provided as guidance only. If you think you may have depression, it is important that you seek the advice of a medical professional before purchasing any medication. Your doctor will be able to prescribe an antidepressant most suited to you.

Image: Wikimedia File:Prozac pills.jpg