Diabetes with comorbid depression: Role of SSRI in better glycemic control

Gehlawat, Pratibha; Gupta, Rajiv Kumar; Rajput, Rajesh; Gahlan, Deepak; Gehlawat, Virender Kumar

doi:10.1016/j.ajp.2013.03.007

Cited by 24 publications

(20 citation statements)

References 26 publications

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“…4. In an open-label 12-week follow-up study, Gehlawat et al (25) investigated the effect of ecitalopram (10–20 mg/day) in outpatients with DM with comorbid depression, the relationship of treatment response for depression, and glycaemic control. A total of 40 patients (30 females and 10 males) were included with a mean age of 50.75 years.…”

Section: Resultsmentioning

confidence: 99%

Use of antidepressants in patients with depression and comorbid diabetes mellitus: a systematic review

Roopan

Larsen

2016

Acta Neuropsychiatr.

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From these data, we will recommend choosing an selective serotonin reuptake inhibitor (SSRI) if possible to treat a depression among patients with diabetes. If treatment with a tricyclic antidepressant is needed, closer glycaemic monitoring is recommended. Bear in mind that there is a possible risk of hypoglycemia when using SSRIs. Agomelatine and bupropion have shown promising results, but need to be investigated in more trials.

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Section: Resultsmentioning

confidence: 99%

Use of antidepressants in patients with depression and comorbid diabetes mellitus: a systematic review

Roopan

Larsen

2016

Acta Neuropsychiatr.

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“…Selective 5‐HT reuptake inhibitors (SSRIs) represent the most commonly prescribed antidepressants. These pharmacological agents, including escitalopram or sertraline, are effective in treating MD in patients with T2DM (Williams et al ., ; Gehlawat et al ., ). However, other clinical studies have led to the opposite conclusions (Anderson et al ., ; Gois et al ., ), as a significant proportion of patients with T2DM suffering from MD do not achieve remission with SSRI treatment.…”

Section: Introductionmentioning

confidence: 99%

High‐fat diet‐induced metabolic disorders impairs 5‐HT function and anxiety‐like behavior in mice

Zemdegs

Quesseveur

Jarriault

et al. 2015

British J Pharmacology

143

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BACKGROUND AND PURPOSEThe link between type 2 diabetes mellitus (T2DM) and depression is bidirectional. However, the possibility that metabolic disorders may elicit anxiogenic-like/depressive-like symptoms or alter the efficacy of antidepressant drugs remains poorly documented. This study explored the influence of T2DM on emotionality and proposed a therapeutic strategy that might be used in depressed diabetic patients. EXPERIMENTAL APPROACHMice were fed a high-fat diet (HFD) and subjected to a full comprehensive metabolic and behavioural analysis to establish correlations between metabolic and psychiatric disorders. In vivo intra-hippocampal microdialysis was also applied to propose a mechanism underpinning the phenotype of mice fed the HFD. Finally, we tested whether chronic administration of the selective 5-HT reuptake inhibitor escitalopram or HFD withdrawal could reverse HFD-induced metabolic and behavioural anomalies. KEY RESULTSThe increased body weight, hyperglycaemia and impaired glucose tolerance in response to HFD were correlated with anxiogeniclike/depressive-like symptoms. Moreover, this phenotype was associated with decreased extracellular 5-HT levels in the hippocampus which may result from increased sensitivity of the dorsal raphe 5-HT 1A autoreceptor. Interestingly, the beneficial effect of prolonged administration of escitalopram was abolished in HFD-fed mice. On the contrary, HFD withdrawal completely reversed metabolic impairments and positively changed symptoms of anxiety, although some behavioural anomalies persisted. CONCLUSIONS AND IMPLICATIONSOur data provide clear-cut evidence that both pathologies are finely correlated and associated with impaired 5-HT mediated neurotransmission in the hippocampus. Further experiments are warranted to define the most adequate strategy for the treatment of such co-morbidity. LINKED ARTICLES

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“…A study done by Gehlawat et al in 2013 14 demonstrated a significant decline in mean HDRS scores which was observed 3 weeks onwards till the end of the study during Escitalopram therapy. Also, there was a corresponding decline in mean fasting and post-prandial plasma glucose level at 6 and 12 weeks respectively and glycosylated hemoglobin level at 12 weeks was observed.…”

Section: Discussionmentioning

confidence: 90%

Untitled

2015

IJPSR

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Introduction: A bidirectional relationship exists between type 2 diabetes mellitus (T2DM) and depression. There is dearth of research on comparative suitability of different antidepressants in people with T2DM and depression. Aim: To compare the effects of Escitalopram and Agomelatine on glycemic control and symptoms of depression in patients with T2DM and depression. Materials and Methods: We conducted a randomized, open label, parallel groups study. Patients diagnosed as T2DM with moderate to severe depression (Hamilton Depression Rating Scale Score ≥ 14) were randomized to receive either Escitalopram (10 mg daily) or Agomelatine (25 mg daily) along with antidiabetic agents as per American Diabetes Association (ADA), 2013 guidelines. Depression was assessed using HDRS and Montgomery Asberg Depression Rating Scale (MADRS). Results: Escitalopram group showed a significant reduction in FBG and HbA1Cvalues as compared to Agomelatine group at 1 and 2 months. HDRS scores of Escitalopram group were significantly lower than Agomelatine group at 1 and 2 months (8.85 ± 5.86 and15.6 ± 2.5 respectively). Similarly, Escitalopram group showed significantly lower MADRS scoresthan Agomelatine group at 1 and 2 months (13.6 ± 1.85 and 21.15 ± 2.34 respectively). Conclusion: Escitalopram seems to be better than Agomelatinefor glycemic control and ameliorating symptoms of depression in patients of T2DM and depression.

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Diabetes with comorbid depression: Role of SSRI in better glycemic control

Cited by 24 publications

References 26 publications

Use of antidepressants in patients with depression and comorbid diabetes mellitus: a systematic review

Use of antidepressants in patients with depression and comorbid diabetes mellitus: a systematic review

High‐fat diet‐induced metabolic disorders impairs 5‐HT function and anxiety‐like behavior in mice

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