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Disclosures: The authors report no relevant financial disclosures.
July 10, 2020
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Antidepressants elevate risk for type 2 diabetes

Source/Disclosures
Disclosures: The authors report no relevant financial disclosures.
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A cohort of French women currently taking any antidepressant medication were more likely to develop type 2 diabetes during 6 years of follow-up compared with nonusers, independent of severe depressive symptoms.

“Although meta-analyses concluded that the use of antidepressants is associated with an increased risk for type 2 diabetes, longitudinal studies found no association between the use of antidepressants and change in glucose levels over time,” Marine Azevedo Da Silva, PhD, a postdoctoral researcher at the Institute for Health and Social Policy at McGill University in Montreal, told Healio. “Therefore, the association remains debated and requires additional studies — mainly, studies that can take into account the evolution over time of the use of different classes of antidepressants.”

Risks for incident type 2 diabetes with current antidepressant use:

Azevedo Da Silva and colleagues analyzed data from 63,999 women without type 2 diabetes at baseline participating in the E3N study, a French cohort study initiated in 1990 with questionnaire-based follow-up every 2 or 3 years (mean age, 64 years). Researchers assessed exposure to antidepressants and incident cases of type 2 diabetes during a median 6.4 years of follow-up (2005-2011) via drug reimbursement files available beginning in 2004, which were individually matched with questionnaire data. Researchers used Cox proportional hazard regression models to examine the relationship between antidepressant use and incident type 2 diabetes.

Within the cohort, 16,779 (26%) of women used antidepressants at least once during follow-up, and 1,124 women developed type 2 diabetes during follow-up.

Marine Azevedo Da Silva

Current use of antidepressants was associated with a 34% increased risk for developing type 2 diabetes (HR = 1.34; 95% CI, 1.12-1.61) compared with nonusers. In analyses stratified by antidepressant type, type 2 diabetes risk varied when compared with nonusers. Women who currently used selective serotonin reuptake inhibitors were 25% more likely to develop type 2 diabetes during follow-up vs. nonusers (HR = 1.25; 95% CI, 0.99-1.57); the risk was greater for women who currently used imipramine-type antidepressants (HR = 1.66; 95% CI, 1.12-2.46), other antidepressants (HR = 1.35; 95% CI, 1-1.84) or mixed antidepressants (HR = 1.82; 95% CI, 0.85-3.86). The risks were only marginally attenuated after factoring in BMI information from a 2008 questionnaire, according to researchers.

“In this study of more than 60,000 women followed for 6 years, we have observed an increased risk for type 2 diabetes associated with the use of any antidepressant,” Azevedo Da Silva said. “Women currently using antidepressants have a 34% higher risk for developing type 2 diabetes compared with nonusers.”

The researchers noted that if the association is confirmed, screening and surveillance of glucose levels should be considered in the context of antidepressant therapy.

For more information:

Marine Azevedo Da Silva, PhD, can be reached at McGill University, Institute for Health and Social Policy, Montreal, Quebec H3A 1A3, Canada; email: marine.azevedodasilva@mcgill.ca.