Comparison of Fluoxetine and Paroxetine in Type II Diabetes Mellitus Patients

Gülseren, Leyla; Gülseren, Şeref; Hekimsoy, Zeliha; Mete, Levent

doi:10.1016/j.arcmed.2004.12.018

Cited by 67 publications

(54 citation statements)

References 22 publications

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“…In the 2010 review, most SSRI studies did almost as well as the only non-SSRI study, with nortriptyline, which had a slightly higher effect size; all effect sizes were large except in one small study [31]. Fluoxetine [27,28], sertraline [38], nortryptiline [29] and paroxetine [30][31][32] yielded significant improvements in depressive symptoms. Fluoxetine was also associated with weight loss, lower glucose and lipids [27,28].…”

Section: Interpretation Of Pharmacotherapeutic Outcomes: Antidepressantsmentioning

confidence: 99%

“…Sertraline was effective in relapse prevention [40], and both sertraline and paroxetine improved comorbid anxiety, quality of life and general functioning [30][31][32]40]. There was no influence on glycemic control except in cases of fluoxetine [27,28] and sertraline [40]. Although the improvement of glycemic control seems hopeful, the reported level of improvement (-0.4% of HbA1c) is too low to be clinically relevant in view of regular strategies to improve blood glucose levels such as those described by the Institute for Healthcare Improvement.…”

Section: Interpretation Of Pharmacotherapeutic Outcomes: Antidepressantsmentioning

confidence: 99%

“…Fluoxetine [27,28], sertraline [38], nortryptiline [29] and paroxetine [30][31][32] yielded significant improvements in depressive symptoms. Fluoxetine was also associated with weight loss, lower glucose and lipids [27,28]. Sertraline was effective in relapse prevention [40], and both sertraline and paroxetine improved comorbid anxiety, quality of life and general functioning [30][31][32]40].…”

Section: Interpretation Of Pharmacotherapeutic Outcomes: Antidepressantsmentioning

confidence: 99%

“…Several treatments for comorbid depression in diabetes mellitus have been evaluated, such as counseling [22][23][24], cognitive-behavioral therapy (CBT) [25,26], antidepressant treatment [27][28][29][30][31][32] and collaborative care [33,34]. A systematic review and meta-ana lysis evaluating these randomized controlled trials (RCTs) was published in 2010 [35].…”

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confidence: 99%

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Comorbid diabetes and depression: do E-health treatments achieve better diabetes control?

Feltz-Cornelis¹

2013

Diabetes Management

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SUMMARYResearch in the field of comorbid depression in diabetes shows that the optimum treatment to attain better diabetes disease control is still undecided. Although several treatment models are effective and available, interventions aimed at improving disease control, such as glycemic control, are less effective, with moderate evidence for pharmacological treatment and a lot of evidence for psychotherapy in combination with self-management techniques. New developments such as M-health and E-health are much less effective and show much less effect in terms of glycemic control than earlier developed, face-to-face psychotherapeutic treatments, and demonstrate higher mortality rates in patients with diabetes mellitus or with multimorbidity, which gives reason for caution in the evaluation, testing and implementation of E-health and M-health models in patients with diabetes and depression. Further research into blended E-health models, in which the clinical diagnostic and treatment evaluation is strongly embedded, and with a focus not only on depression treatment, but also on diabetes control and taking mortality into account as outcome, is needed. Treatment of comorbid depression in diabetes mellitus is effective in achieving improvement of depression outcomes, with the largest effects seen for psychotherapy and pharmacotherapy.However, treatment effects are inconclusive or small in terms of diabetes control; the effects of face-to-face psychotherapeutic treatment and pharmacotherapy are largest.Treatment with E-health and M-health so far shows disappointing results. Effects on diabetes control are small to nil, and mortality rates may be higher, demonstrating that newer treatments are not always better.Claims of cost-effectiveness of E-health so far have not been substantiated for this kind of treatment either and there is no basis for grand-scale implementation of E-health or M-health at the moment.Future research should be aimed at interventions combining depression treatment with treatment specifically aimed at diabetes control, taking into account not only glycemic control, but also complications and mortality, in patients with depression and diabetes.Future research should evaluate blended models combining E-health with clinical care, which may have the best potential.

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Section: Interpretation Of Pharmacotherapeutic Outcomes: Antidepressantsmentioning

confidence: 99%

Section: Interpretation Of Pharmacotherapeutic Outcomes: Antidepressantsmentioning

confidence: 99%

Section: Interpretation Of Pharmacotherapeutic Outcomes: Antidepressantsmentioning

confidence: 99%

mentioning

confidence: 99%

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Comorbid diabetes and depression: do E-health treatments achieve better diabetes control?

Feltz-Cornelis¹

2013

Diabetes Management

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“…Antidepressants such as selective serotonin reuptake inhibitors (SSRIs), including paroxetine, are commonly used in diabetic patients. Paroxetine improved glucose metabolism and insulin sensitivity via alleviating depression [10,11] , although antidepressant use that was associated with disturbances in glucose homeostasis has been reported [12,13] .…”

Section: Introductionmentioning

confidence: 99%

Co-administration of paroxetine and pravastatin causes deregulation of glucose homeostasis in diabetic rats via enhanced paroxetine exposure

Zhang

et al. 2014

Acta Pharmacol Sin

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Aim: Clinical evidence shows that co-administration of pravastatin and paroxetine deregulates glucose homeostasis in diabetic patients. The aim of this study was to verify this phenomenon in diabetic rats and to elucidate the underlying mechanisms. Methods: Diabetes mellitus was induced in male SD rats by a high-fat diet combined with a low-dose streptozotocin injection. The rats were orally administered paroxetine (10 mg/kg) and pravastatin (10 mg/d) or both the drugs daily for 28 d. The pharmacokinetics of paroxetine and pravastatin were examined on d 1 and d 28. Biochemical parameters including serum insulin, glucose and lipids were monitored during the treatments. An insulin-secreting cell line (INS-1) was used for measuring insulin secretion. Results: In diabetic rats, co-administration of paroxetine and pravastatin markedly increased the concentrations of both the drugs compared with administration of each drug alone. Furthermore, co-administration severely impaired glucose homeostasis in diabetic rats, as demonstrated by significantly increased serum glucose level, decreased serum and pancreatic insulin levels, and decreased pancreatic Insulin-2 mRNA and tryptophan hydroxylase-1 (Tph-1) mRNA levels. Treatment of INS-1 cells with paroxetine (5 and 10 μmol/L) significantly inhibited insulin secretion, decreased the intracellular insulin, 5-HT, Insulin-2 mRNA and Tph-1 mRNA levels. Treatment of the cells with pravastatin (10 μmol/L) significantly stimulated insulin secretion, which was weakened by co-treatment with paroxetine. Conclusion: Paroxetine inhibits insulin secretion at least via decreasing intracellular 5-HT and insulin biosynthesis. The deregulation of glucose homeostasis by co-administration of paroxetine and pravastatin in diabetic rats can be attributed to enhanced paroxetine exposure.

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Paroxetine versus other anti-depressive agents for depression

Purgato

Papola

Gastaldon

et al. 2014

Cochrane Database of Systematic Reviews

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Some possibly clinically meaningful differences between paroxetine and other ADs exist, but no definitive conclusions can be drawn from these findings. In terms of response, there was a moderate quality of evidence that citalopram was better than paroxetine in the acute phase (six to 12 weeks), although only one study contributed data. In terms of early response to treatment (one to four weeks) there was moderate quality of evidence that mirtazapine was better than paroxetine and that paroxetine was better than reboxetine. However there was no clear evidence that paroxetine was better or worse compared with other antidepressants at increasing response to treatment at any time point. Even if some differences were identified, the findings from this review are better thought as hypothesis forming rather than hypothesis testing and it would be reassuring to see the conclusions replicated in future trials. Finally, most of included studies were at unclear or high risk of bias, and were sponsored by the drug industry. The potential for overestimation of treatment effect due to sponsorship bias should be borne in mind.

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Comparison of Fluoxetine and Paroxetine in Type II Diabetes Mellitus Patients

Cited by 67 publications

References 22 publications

Comorbid diabetes and depression: do E-health treatments achieve better diabetes control?

Comorbid diabetes and depression: do E-health treatments achieve better diabetes control?

Co-administration of paroxetine and pravastatin causes deregulation of glucose homeostasis in diabetic rats via enhanced paroxetine exposure

Paroxetine versus other anti-depressive agents for depression

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