Long-term antidepressant use and the risk of type 2 diabetes mellitus: A population-based, nested case-control study in Taiwan
Journal
Journal of Clinical Psychiatry
Journal Volume
75
Journal Issue
1
Pages
31-38
Date Issued
2014
Author(s)
Abstract
Objective: Antidepressant drugs might induce weight gain and increase diabetes risk. We examined the diabetes risk with long-term antidepressant use in a general population. Method: This study was a population-based, nested case-control study using Taiwan's National Health Insurance Research Database between 1998 and 2009. A total of 47,885 patients with type 2 diabetes mellitus (ICD-9 codes: 250.x; excluding 250.x 1 and 250.x 3) and 95,770 controls were identified. We used a conditional logistic regression model for data analysis and 1-year latent period before the diabetes diagnosis to account for the quantification of treatment duration of antidepressant (defined by Anatomic Therapeutic Chemical classification code N06A). Sensitivity analyses were performed using a propensity score matching method, as well as different lengths of latent periods. Results: Compared with nonusers, patients with cumulative antidepressant use (> 2 years) had an increased risk of diabetes (adjusted OR = 1.20; 95% CI, 1.05-1.37). Moreover, increasing mean daily dose or use of selective serotonin reuptake inhibitors or serotonin antagonist and reuptake inhibitors was associated with increased diabetes risk. The increased diabetes risk with long-term antidepressant therapy in patients aged 44 years or less (adjusted OR = 2.39; 95% CI, 1.46-3.90) was higher than that in older adults (adjusted OR = 1.15; 95% CI, 1.00-1.32). Conclusions: The findings suggest that long-term antidepressant use may be associated with an increased risk of type 2 diabetes mellitus, especially for young adults. Therefore, long-term antidepressant use should be evaluated more cautiously for its benefits and the potential risk of diabetes. ? Copyright 2014 Physicians Postgraduate Press, Inc.
SDGs
Other Subjects
amfebutamone; amitriptyline; antidepressant agent; citalopram; clomipramine; dosulepin; doxepin; duloxetine; escitalopram; fluoxetine; fluvoxamine; imipramine; maprotiline; melitracen; milnacipran; mirtazapine; paroxetine; serotonin antagonist; serotonin noradrenalin reuptake inhibitor; serotonin uptake inhibitor; sertraline; tetracyclic antidepressant agent; trazodone; tricyclic antidepressant agent; venlafaxine; adult; aged; article; controlled study; data analysis; data base; disease association; drug use; female; human; logistic regression analysis; long term care; major clinical study; male; middle aged; non insulin dependent diabetes mellitus; population based case control study; priority journal; propensity score; risk assessment; risk benefit analysis; sensitivity analysis; Taiwan; treatment duration; weight gain; young adult; Adult; Age Factors; Aged; Antidepressive Agents; Case-Control Studies; Diabetes Mellitus, Type 2; Humans; Middle Aged; Odds Ratio; Registries; Risk; Serotonin Antagonists; Serotonin Uptake Inhibitors; Taiwan; Time Factors; Young Adult
Type
journal article