Antidepressants and Diabetes

Aggressive treatment for depression may increase your risk for diabetes, at least if you live in Canada. The journal Diabetes Research & Clinical Practice reported a study finding a 30 per cent increased risk of diabetes among people who have been treated for diabetes.

Analyzing the data a little further, researcher Lauren Brown then took a closer look at the medications given 2,400 people diagnosed with depression and their risk of diabetes. Dr. Brown found that treating depression with two different classes of antidepressants at the same time nearly doubled the risk of diabetes. Specifically, the risk of diabetes was nearly 200 per cent greater when patients were given both a tricyclic antidepressant (TCAs) and a selective serotonin reuptake inhibitor (SSRIs).

Tricyclic antidepresants, which are not used very often in the US except for treating nerve damage, include:

amitriptyline (Elavil), nortriptyline (Pamelor), desipramine (Norpramin), clomipramine (Anafranil), doxepin (Sinequan), protriptyline (Vivactil), trimipramine (Surmontil), and imipramine (Tofranil).

Selective serotonin reuptake inhibitors include:

SSRIs include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro).

It is the combination of these classes of medication that raised the risk of diabetes in the Canadian study. Dr. Brown noted that "emphasize the need for regular screening for type 2 diabetes in people with depression, particularly those taking more than one antidepressant. "

Two caveats for interpreting these results apply. One is that the patients in the study lived in Saskatchewan. It's possible that short winter day length played a role in developing diabetes, and that this factor would not apply, say, in Mexico or India or Hawaii. The second caveat is that this study did not analyze the effects of the selective serotonin/norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Effexor) and duloxetine (Cymbalta). This class of antidepressants, however, has also been associated with difficulties with blood sugar control. It's prudent for anyone receiving medication for depression to have tests for high blood sugar and incipient diabetes as a regular part of followup care.

You may also be interested in:

Could Diabetes Be Caused by a Dysfunctional Body Clock?
Buying Insulin Doesn't Have to Break Your Budget
Diabetics: Lower Your Blood Sugars 1-2-3