Antidepressant medicine use and risk of developing diabetes during the diabetes prevention program and diabetes prevention program outcomes study

Richard R Rubin, Yong Ma, Mark Peyrot, David G Marrero, David W Price, Elizabeth Barrett-Connor, William C Knowler, Diabetes Prevention Program Research Group

Abstract

Objective: To assess the association between antidepressant medicine use and risk of developing diabetes during the Diabetes Prevention Program (DPP) and Diabetes Prevention Program Outcomes Study (DPPOS).

Research design and methods: DPP/DPPOS participants were assessed for diabetes every 6 months and for antidepressant use every 3 months in DPP and every 6 months in DPPOS for a median 10.0-year follow-up.

Results: Controlled for factors associated with diabetes risk, continuous antidepressant use compared with no use was associated with diabetes risk in the placebo (adjusted hazard ratio 2.34 [95% CI 1.32-4.15]) and lifestyle (2.48 [1.45-4.22]) arms, but not in the metformin arm (0.55 [0.25-1.19]).

Conclusions: Continuous antidepressant use was significantly associated with diabetes risk in the placebo and lifestyle arms. Measured confounders and mediators did not account for this association, which could represent a drug effect or reflect differences not assessed in this study between antidepressant users and nonusers.

Trial registration: ClinicalTrials.gov NCT00038727.

Figures

Figure 1
Figure 1
For each treatment group, from left to right, the three bars represent no exposure, intermittent exposure, and continuous exposure. The error bars represent 95% CIs for the point estimates.

References

    1. Rubin RR, Ma Y, Marrero DG, Peyrot M, Barrett-Connor EL, Kahn SE, Haffner SM, Price DW, Knowler WC: Diabetes Prevention Program Research Group Elevated depression symptoms, antidepressant medicine use, and risk of developing diabetes during the Diabetes Prevention Program. Diabetes Care 2008;31:420–426
    1. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM: Diabetes Prevention Program Research Group Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346:393–403
    1. Diabetes Prevention Program Research Group, Knowler WC, Fowler SE, Hamman RF, Christophi CA, Hoffman HJ, Brenneman AT, Brown-Friday JO, Goldberg R, Venditti E, Nathan DM: 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet 2009;374:1677–1686
    1. Andersohn F, Schade R, Suissa S, Garbe E: Long-term use of antidepressants for depressive disorders and the risk of diabetes mellitus. Am J Psychiatry 2009;166:591–598
    1. Brown LC, Majumdar SR, Johnson JA: Type of antidepressant therapy and risk of type 2 diabetes in people with depression. Diabetes Res Clin Pract 2008;79:61–67
    1. Atlantis E, Browning C, Sims J, Kendig H: Diabetes incidence associated with depression and antidepressants in the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA). Int J Geriatr Psychiatry 2010;25:688–696
    1. Cubeddu LX, Bönisch H, Göthert M, Molderings G, Racké K, Ramadori G, Miller KJ, Schwörer H: Effects of metformin on intestinal 5-hydroxytryptamine (5-HT) release and on 5-HT3 receptors. Naunyn Schmiedebergs Arch Pharmacol 2000;361:85–91
    1. Caballero AE, Delgado A, Aguilar-Salinas CA, Herrera AN, Castillo JL, Cabrera T, Gomez-Perez FJ, Rull JA: The differential effects of metformin on markers of endothelial activation and inflammation in subjects with impaired glucose tolerance: a placebo-controlled, randomized clinical trial. J Clin Endocrinol Metab 2004;89:3943–3948
    1. Miller AH, Maletic V, Raison CL: Inflammation and its discontents: the role of cytokines in the pathophysiology of major depression. Biol Psychiatry 2009;65:732–741

Source: PubMed

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