Antidepressant use, depression, lifestyle factors, and new-onset diabetes.

aSchool of Pharmacy, Department of Pharmaceutical Systems and Policy, West Virginia University, Morgantown, West Virginia 26505, USA.
International clinical psychopharmacology (Impact Factor: 3.35). 05/2011; 26(3):159-68. DOI: 10.1097/YIC.0b013e328342ce31
Source: PubMed

ABSTRACT We assessed the short-term association between antidepressant drug use and the risk of new-onset diabetes in 2-years of observation. This study used longitudinal data from the Medical Expenditure Panel Survey for years 2004-2007. Chi-square tests and logistic regressions were used to examine the link between use of antidepressants with and without depression, and new-onset diabetes, after controlling for independent variables in blocks. In unadjusted models, the risk of new-onset diabetes was significantly increased for persons using antidepressants with depression compared with those without antidepressant use or depression [odds ratio (OR)=2.12, 95% confidence interval (CI): 1.45-3.09]. When lifestyle risk factors were entered in the model, statistical significance disappeared [adjusted OR (AOR)=1.42, 95% CI: 0.98-2.08]. Independently, lifestyle risk factors significantly increased the risk of new-onset diabetes: hypertension (AOR=2.55, 95% CI: 1.86-3.50, P<0.001), lipid disorders (AOR=1.60, 95% CI: 1.14-2.24), overweight (AOR=2.01, 95% CI: 1.35-2.98), obesity (AOR=3.57, 95% CI: 2.50-5.10), and no physical exercise (AOR=1.98, 95% CI: 1.53-2.57, P<0.001). Future studies on the risk of new-onset diabetes by duration and intensity of antidepressant use and depression are needed.

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    ABSTRACT: Aims We evaluated the association of combined use ofantidepressants andstatinsand the risk of new-onset diabetes among high-risk adults. Methods We used a retrospective, observational, longitudinal design among adults (age≥22 years) who were diabetes free at baseline and had reported hypertension or hyperlipidemia or heart disease. We used data were from 2004-2009 Medical Expenditure panel Survey and identified from self-reported diabetes or insulin use. We categorized antidepressants andstatins use into four groups: antidepressants only, statins only, combined use of antidepressants and statins (antidepressants-statins), and neither antidepressant nor statins.We conducted chi-square and multivariable logistic regressions to examine the association between use of antidepressants-statinsand new-onset diabetes after controlling fordemographic and economic characteristics, health-status, access to care, presence of depression, and lifestyle risk factors. Results In our study sample, 9.3% used antidepressants only, 10.7% used statins only and 2.4% adults reported use of antidepressants-statins. Nearly 2% of the study sample reportednew-onset diabetes. In unadjusted analyses, significantly higher proportion of adults using antidepressants-statins (3.2%) reported new-onset diabetes compared to those using neither antidepressants nor statins (1.1%).However, after controlling for all other variables in multivariable regression we did not observe a statistically significant association between use of antidepressants-statins and new-onset diabetes. Conclusions Our study results do not suggest that use ofantidepressants-statins may increase the risk of new-onset diabetes. Future research needs to examine this relationship with specific combinations of these drug classes and using longer follow up periods.
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    ABSTRACT: BACKGROUND: Antidepressant use has been linked to new-onset diabetes. However, the existing literature on this relationship has yielded inconsistent findings. The primary objective of this study was to systematically synthesize the literature on the relationship between antidepressant use and new-onset diabetes using meta-analysis. METHODS: A systematic literature search was conducted to identify relevant studies in seven electronic databases. Two independent reviewers identified the final list of studies to be included in the meta-analysis using a priori selection criteria. Results for the primary outcome of interest, i.e., odds and hazards of developing new-onset diabetes, were pooled using a random-effects model. Egger's regression test and the Trim and Fill method were utilized to detect the presence of any potential publication bias. Sensitivity analysis was conducted using the leave-one-out method as well as individual categories of antidepressant drugs. RESULTS: Eight studies met the inclusion criteria. Random effects models revealed that adults with any use of antidepressants were more likely to develop new-onset diabetes compared to those without any use of antidepressants (OR = 1.50, 95% CI 1.08-2.10; HR = 1.19, 95% CI 1.08-1.32). Sensitivity analyses revealed fair robustness. SSRIs and TCAs were more likely to be associated with the development of new-onset diabetes. Results from the Egger's regression test and Trim and Fill method revealed no evidence of publication bias. CONCLUSIONS: Among adults, antidepressant use was associated with higher chances of new-onset diabetes. However, since a cause-and-effect relationship cannot be established by observational studies, future randomized controlled studies are needed to confirm this association. Copyright © 2013 John Wiley & Sons, Ltd.
    Diabetes/Metabolism Research and Reviews 02/2013; · 3.59 Impact Factor
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    ABSTRACT: 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. 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. 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). Our results suggest that the use of antidepressants is associated with an increased risk of DM.
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