Rubin RR, Ma Y, Marrero DG, et al. Elevated depression symptoms, antidepressant medicine use, and risk of developing diabetes during the Diabetes Prevention Program. Diabetes Care. 2008;31:420-426.
These data are provocative. This raises the question of whether antidepressants can play some kind of etiologic role in the induction of diabetes in people who are susceptible. It makes me wonder whether use of these agents could be doing something bad. I think antidepressants are good at treating depression, and people are going to treat with these drugs even if there is an increased risk for conversion to diabetes in susceptible people. I suppose if you are going to use antidepressants, you should get baseline values on your patients and watch them if it looks like they have any risk factors for diabetes. Based on studies like this one, you want to perhaps screen these patients a little more carefully. The whole issue of depression is hard to quantitate. These researchers are saying that people treated with antidepressants had a higher incidence of conversion to diabetes. But the reasons are apparently not clear. There was no association with body weight gain. This study also raises the question, to which we do not have an answer at the moment: can this be replicated in other studies? Maybe we need a large-scale clinical trial to look at this.
– Philip Levy, MD
Endocrine Today Editorial Board member