Elevated Depressive Symptoms, Antidepressant Use, and Diabetes in a Large Multiethnic National Sample of Postmenopausal Women

Ma, Yunsheng; Balasubramanian, Raji; Pagoto, Sherry L.; Schneider, Kristin L.; Culver, Annie L.; Olendzki, Barbara C.; Tinker, Lesley F.; Liu, Simin; Safford, Monika M.; Sepavich, Deidre M.; Rosal, Milagros C.; Ockene, Judith K.; Carnethon, Mercedes R.; Zorn, Martha; Hébert, James R.

doi:10.2337/dc11-1223

Cited by 31 publications

(45 citation statements)

References 15 publications

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“…But the elevated risk of DM in the USA7,8,14,33-35) (RR, 1.50; 95% CI, 1.25 to 1.80) was similar to that in other countries9,10,13,23,36,37) (RR, 1.48; 95% CI, 1.18 to 1.85). According to type of study, the pooled estimate of cohort studies was slightly lower than that of case-control studies.…”

Section: Resultssupporting

confidence: 60%

“…The pooled risk ratio of high quality studies7-9,13,14,33-37) was particularly higher than overall results (RR, 1.67; 95% CI, 1.39 to 2.01).…”

Section: Resultsmentioning

confidence: 69%

“…Regarding the duration of medication, the risk of DM in the subgroups over 1 year of use7,9,13,36) (RR, 1.61; 95% CI, 1.30 to 1.99) was relatively higher than within 1 year of use13,36) (RR, 1.26; 95% CI, 1.01 to 1.57).…”

Section: Resultsmentioning

confidence: 92%

“…However, a pooled estimate of studies controlling physical activity7,10,14,33,37) (RR, 1.18; 95% CI, 1.09 to 1.27) was attenuated comparing the overall result in the random effect model.…”

Section: Resultsmentioning

confidence: 93%

“…The countries in which the studies had been conducted were as follows: the United States (n = 6),7,8,14,33-35) Netherlands (n = 1),11) the UK (n = 1),36) Finland (n = 1),9) Norway (n = 1),10) Australia (n = 1),37) and multiple countries (n = 1) 13). We identified 15 eligible estimates from 3 nested case control articles,9,13,36) 6 retrospective cohort studies,8,10,11,14,33,35) and 3 prospective cohort studies 7,34,37). Ten studies included both SSRIs and TCAs as antidepressants.…”

Section: Resultsmentioning

confidence: 99%

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Antidepressant Use and Diabetes Mellitus Risk: A Meta-Analysis

et al. 2013

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BackgroundEpidemiologic 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.MethodsWe 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.ResultsOut 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).ConclusionOur results suggest that the use of antidepressants is associated with an increased risk of DM.

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Section: Resultssupporting

confidence: 60%

“…The pooled risk ratio of high quality studies7-9,13,14,33-37) was particularly higher than overall results (RR, 1.67; 95% CI, 1.39 to 2.01).…”

Section: Resultsmentioning

confidence: 69%

Section: Resultsmentioning

confidence: 92%

“…However, a pooled estimate of studies controlling physical activity7,10,14,33,37) (RR, 1.18; 95% CI, 1.09 to 1.27) was attenuated comparing the overall result in the random effect model.…”

Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

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Antidepressant Use and Diabetes Mellitus Risk: A Meta-Analysis

et al. 2013

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Antidepressant use and new‐onset diabetes: a systematic review and meta‐analysis

Bhattacharjee

Bhattacharya

Kelley

et al. 2013

Diabetes Metabolism Res

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Summary 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. 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, that is, 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. 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 with those without any use of antidepressants [odd ratios = 1.50, 95% confidence interval (CI), 1.08–2.10; hazards ratio = 1.19, 95% CI, 1.08–1.32]. Sensitivity analyses revealed fair robustness; selective serotonin reuptake inhibitors and tricyclic antidepressants 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. Among adults, antidepressant use was associated with higher chances of new-onset diabetes. However, because a cause-and-effect relationship cannot be established by observational studies, future randomized controlled studies are needed to confirm this association.

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Antidepressant use and glycemic control

Mojtabai

2013

Psychopharmacology

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Elevated Depressive Symptoms, Antidepressant Use, and Diabetes in a Large Multiethnic National Sample of Postmenopausal Women

Cited by 31 publications

References 15 publications

Antidepressant Use and Diabetes Mellitus Risk: A Meta-Analysis

Antidepressant Use and Diabetes Mellitus Risk: A Meta-Analysis

Antidepressant use and new‐onset diabetes: a systematic review and meta‐analysis

Antidepressant use and glycemic control

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