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

Published online by Cambridge University Press:  25 October 2016

Subethini Roopan  and
Erik Roj Larsen
Subethini Roopan
Affiliation:
Psychiatric Department Kolding-Vejle, Region of Southern Denmark, Denmark
Erik Roj Larsen*
Affiliation:
Department of Affective Disorders Q, Mood Disorders Research Unit, Aarhus University Hospital, Risskov, Denmark
*
Erik Roj Larsen, Department of Affective Disorders Q, Mood Disorders Research Unit, Aarhus University Hospital, Risskov DK-8240, Denmark. Tel: +45 78 47 21 30; E-mail: erlars@rm.dk
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Abstract

Objective

Depression may be difficult to treat and with comorbid diabetes mellitus (DM) it is an even bigger challenge. This article aims to evaluate antidepressants most suitable for patients with depression and comorbid DM.

Design and methods

Initially we searched for randomised, controlled double-blind trials of treatment with antidepressants in depressed with DM but there were only a few studies and many of them were small trials. Thus, we decided to include studies that were not only randomised-controlled trials. In total, we ended up with 18 articles for our purposes.

Results

The combination of depression and DM may be harmful as depression has a strong impact on psychosocial and medical outcomes in patients with DM. Almost all of the trials in this review showed a reduction in depressive symptoms after treatment with an antidepressant in the acute as well as during maintenance phase. It showed that depression improvement had a favourable effect on glycaemic control that was weight independent. Some studies included only subjects with minor depression or with suboptimal-controlled diabetes making it difficult to show an effect.

Conclusion

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.

Keywords

antidepressantdepressiondiabetes mellitusmood disorder
Type
Review Article
Information
Acta Neuropsychiatrica , Volume 29 , Issue 3 , June 2017 , pp. 127 - 139
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Copyright
© Scandinavian College of Neuropsychopharmacology 2016 

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References

1. Ali, S, Stone, MA, Peters, JL, Davies, MJ, Khunti, K. The prevalence of co-morbid depression in adults with Type 2 diabetes: a systematic review and meta-analysis. Diabet Med 2006;23:1165–1173.Google Scholar
2. Petrak, F, Herpertz, S. Treatment of depression in diabetes: an update. Curr Opin Psychiatry 2009;22:211–217.Google Scholar
3. Lustman, PJ, Clouse, RE, Freedland, KE. Management of major depression in adults with diabetes: implications of recent clinical trials. Semin Clin Neuropsychiatry 1998;3:102–114.Google Scholar
4. Chamberlain, JJ, Rhinehart, AS, Shaefer, CF Jr, Neuman, A. Diagnosis and management of diabetes: synopsis of the 2016 American Diabetes Association Standards of Medical Care in Diabetes. Ann Intern Med 2016;164:542–552.Google Scholar
5. WHO. WHO guidelines approved by the Guidelines Review Committee, in use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus: abbreviated report of a WHO consultation. Geneva: World Health Organization, 2011.Google Scholar
6. Nathan, DM, Turgeon, H, Regan, S. Relationship between glycated haemoglobin levels and mean glucose levels over time. Diabetologia 2007;50:2239–2244.Google Scholar
7. Knol, MJ, Derijks, HJ, Geerlings, MI, et al. Influence of antidepressants on glycaemic control in patients with diabetes mellitus. Pharmacoepidemiol Drug Saf 2008;17:577–586.Google Scholar
8. Weber-Hamann, B, Hentschel, F, Kniest, A, et al. Hypercortisolemic depression is associated with increased intra-abdominal fat. Psychosom Med 2002;64:274–277.Google Scholar
9. Andreoulakis, E, Hyphantis, T, Kandylis, D, Iacovides, A. Depression in diabetes mellitus: a comprehensive review. Hippokratia 2012;16:205–214.Google Scholar
10. Barnard, K, Peveler, RC, Holt, RI. Antidepressant medication as a risk factor for type 2 diabetes and impaired glucose regulation: systematic review. Diabetes Care 2013;36:3337–3345.Google Scholar
11. van der Feltz-Cornelis, CM, Nuyen, J, Stoop, C, et al. Effect of interventions for major depressive disorder and significant depressive symptoms in patients with diabetes mellitus: a systematic review and meta-analysis. Gen Hosp Psychiatry 2010;32:380–395.Google Scholar
12. Baumeister, H, Hutter, N, Bengel, J. Psychological and pharmacological interventions for depression in patients with diabetes mellitus: an abridged Cochrane review. Diabet Med 2014;31:773–786.Google Scholar
13. Petrak, F, Baumeister, H, Skinner, TC, Brown, A, Holt, RI. Depression and diabetes: treatment and health-care delivery. Lancet Diabetes Endocrinol 2015;3:472–485.Google Scholar
14. Erenmemisoglu, A, Ozdogan, UK, Saraymen, R, Tutus, A. Effect of some antidepressants on glycaemia and insulin levels of normoglycaemic and alloxan-induced hyperglycaemic mice. J Pharm Pharmacol 1999;51:741–743.Google Scholar
15. Mahmood, D, Akhtar, M, Vohora, D, Khanam, R. Comparison of antinociceptive and antidiabetic effects of sertraline and amitriptyline on streptozotocin-induced diabetic rats. Hum Exp Toxicol 2010;29:881–886.Google Scholar
16. Gupta, B, Awasthi, A, Jaju, BP. Effect of acute & chronic imipramine treatment on glucose homeostasis. Indian J Med Res 1992;96:65–71.Google Scholar
17. Andersohn, F, Schade, R, Suissa, S, Garbe, E. Long-term use of antidepressants for depressive disorders and the risk of diabetes mellitus. Am J Psychiatry 2009;166:591–598.Google Scholar
18. Brown, LC, Majumdar, SR, Johnson, JA. Type of antidepressant therapy and risk of type 2 diabetes in people with depression. Diabetes Res Clin Pract 2008;79:61–67.Google Scholar
19. Kesim, M., Tiryaki, A, Kadioglu, M, Muci, E, Kalyoncu, NI, Yaris, E. The effects of sertraline on blood lipids, glucose, insulin and HBA1C levels: a prospective clinical trial on depressive patients. J Res Med Sci 2011;16:1525–1531.Google Scholar
20. Weber-Hamann, B, Gilles, M, Lederbogen, F, Heuser, I, Deuschle, M. Improved insulin sensitivity in 80 nondiabetic patients with MDD after clinical remission in a double-blind, randomized trial of amitriptyline and paroxetine. J Clin Psychiatry 2006;67:1856–1861.Google Scholar
21. Ghaeli, P, Shahsavand, E, Mesbahi, M, Kamkar, MZ, Sadeghi, M, Dashti-Khavidaki, S. Comparing the effects of 8-week treatment with fluoxetine and imipramine on fasting blood glucose of patients with major depressive disorder. J Clin Psychopharmacol 2004;24:386–388.Google Scholar
22. Filipcic, I, Margetic, B, Simunovic, I, Jakovljevic, M. Depression treatment and its impact upon the quality of life in patients with diabetes type 2 – the Croatian study. Psychiatr Danub 2010;22:231–235.Google Scholar
23. Amsterdam, JD, Shults, J, Rutherford, N, Schwartz, S. Safety and efficacy of s-citalopram in patients with co-morbid major depression and diabetes mellitus. Neuropsychobiology 2006;54:208–214.Google Scholar
24. Goodnick, PJ, Kumar, A, Henry, JH, Buki, VM, Goldberg, RB. Sertraline in coexisting major depression and diabetes mellitus. Psychopharmacol Bull 1997;33:261–264.Google Scholar
25. Gehlawat, P, Gupta, R, Rajput, R, Gahlan, D, Gehlawat, VK. Diabetes with comorbid depression: role of SSRI in better glycemic control. Asian J Psychiatr 2013;6:364–368.Google Scholar
26. Paile-Hyvarinen, M, Wahlbeck, K, Eriksson, JG. Quality of life and metabolic status in mildly depressed women with type 2 diabetes treated with paroxetine: a single-blind randomised placebo controlled trial. BMC Fam Pract 2003;4:7.Google Scholar
27. Karaiskos, D, Tzavellas, E, Ilias, I, Liappas, I, Paparrigopoulos, T. Agomelatine and sertraline for the treatment of depression in type 2 diabetes mellitus. Int J Clin Pract 2013;67:257–260.Google Scholar
28. Barragan-Rodriguez, L, Rodriguez-Moran, M, Guerrero-Romero, F. Efficacy and safety of oral magnesium supplementation in the treatment of depression in the elderly with type 2 diabetes: a randomized, equivalent trial. Magnes Res 2008;21:218–223.Google Scholar
29. Gulseren, L, Gulseren, S, Hekimsoy, Z, Mete, L. Comparison of fluoxetine and paroxetine in type II diabetes mellitus patients. Arch Med Res 2005;36:159–165.Google Scholar
30. Vasile, D, Vasiliu, O, Vasile, ML, Terpan, M, Ojog, DG. P.2.c.002 Agomelatine versus selective serotoninergic reuptake inhibitors in major depressive disorder and comorbid diabetes mellitus. European Neuropsychopharmacology 2011;21 (Suppl. 3):S383–S384.Google Scholar
31. Khazaie, H, Rahimi, M, Tatari, F, Rezaei, M, Najafi, F, Tahmasian, M. Treatment of depression in type 2 diabetes with fluoxetine or citalopram? Neurosciences (Riyadh) 2011;16:42–45.Google Scholar
32. Lustman, PJ, Griffith, LS, Clouse, RE, et al. Effects of nortriptyline on depression and glycemic control in diabetes: results of a double-blind, placebo-controlled trial. Psychosom Med 1997;59:241–250.Google Scholar
33. Lustman, PJ, Freedland, KE, Griffith, LS, Clouse, RE. Fluoxetine for depression in diabetes: a randomized double-blind placebo-controlled trial. Diabetes Care 2000;23:618–623.Google Scholar
34. Paile-Hyvarinen, M, Wahlbeck, K, Eriksson, JG. Quality of life and metabolic status in mildly depressed patients with type 2 diabetes treated with paroxetine: a double-blind randomised placebo controlled 6-month trial. BMC Fam Pract 2007;8:34.Google Scholar
35. Echeverry, D, Duran, P, Bonds, C, Lee, M, Davidson, MB. Effect of pharmacological treatment of depression on A1C and quality of life in low-income Hispanics and African Americans with diabetes: a randomized, double-blind, placebo-controlled trial. Diabetes Care 2009;32:2156–2160.Google Scholar
36. Lustman, PJ, Clouse, RE, Nix, BD, et al. Sertraline for prevention of depression recurrence in diabetes mellitus: a randomized, double-blind, placebo-controlled trial. Arch Gen Psychiatry 2006;63:521–529.Google Scholar
37. Lustman, PJ, Williams, MM, Sayuk, GS, Nix, BD, Clouse, RE. Factors influencing glycemic control in type 2 diabetes during acute- and maintenance-phase treatment of major depressive disorder with bupropion. Diabetes Care 2007;30:459–466.Google Scholar
38. Komorousova, J, Beran, J, Rusavy, Z, Jankovec, Z. Glycemic control improvement through treatment of depression using antidepressant drugs in patients with diabetes mellitus type 1. Neuro Endocrinol Lett 2010;31:801–806.Google Scholar
39. Derijks, HJ, Heerdink, ER, De Koning, FH, Janknegt, R, Klungel, OH, Egberts, AC. The association between antidepressant use and hypoglycaemia in diabetic patients: a nested case-control study. Pharmacoepidemiol Drug Saf 2008;17:336–344.Google Scholar