Korean J Fam Med.  2013 Jul;34(4):228-240. 10.4082/kjfm.2013.34.4.228.

Antidepressant Use and Diabetes Mellitus Risk: A Meta-Analysis

• Yoon JM
• Cho EG
• Lee HK
• Park SM

• KMID: 2304183
• DOI: http://doi.org/10.4082/kjfm.2013.34.4.228

Abstract

BACKGROUND
Epidemiologic studies have reported inconsistent findings regarding the association between the use of antidepressants and type 2 diabetes mellitus (DM) risk. We performed a meta-analysis to systematically assess the association between antidepressants and type 2 DM risk.
METHODS
We searched MEDLINE (PubMed), EMBASE, and the Cochrane Library (through Dec 31, 2011), including references of qualifying articles. Studies concerning the use of tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), or other antidepressants and the associated risk of diabetes mellitus were included.
RESULTS
Out of 2,934 screened articles, 3 case-control studies, 9 cohort studies, and no clinical trials were included in the final analyses. When all studies were pooled, use of antidepressants was significantly associated with an increased risk of DM in a random effect model (relative risk [RR], 1.49; 95% confidence interval [CI], 1.29 to 1.71). In subgroup analyses, the risk of DM increased among both SSRI users (RR, 1.35; 95% CI, 1.15 to 1.58) and TCA users (RR, 1.57; 95% CI, 1.26 to 1.96). The subgroup analyses were consistent with overall results regardless of study type, information source, country, duration of medication, or study quality. The subgroup results considering body weight, depression severity, and physical activity also showed a positive association (RR, 1.14; 95% CI, 1.01 to 1.28). A publication bias was observed in the selected studies (Egger's test, P for bias = 0.09).
CONCLUSION
Our results suggest that the use of antidepressants is associated with an increased risk of DM.

Keyword

Meta-Analysis; Antidepressive Agents; Serotonin Uptake Inhibitors; Tricyclic Antidepressive Agents; Diabetes Mellitus

MeSH Terms

Antidepressive Agents
Antidepressive Agents, Tricyclic
Bias (Epidemiology)
Body Weight
Case-Control Studies
Cohort Studies
Depression
Diabetes Mellitus
Diabetes Mellitus, Type 2
Motor Activity
Norepinephrine
Publication Bias
Serotonin
Serotonin Uptake Inhibitors
Antidepressive Agents
Antidepressive Agents, Tricyclic
Norepinephrine
Serotonin
Serotonin Uptake Inhibitors