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Long-Term Antidepressant Use and the Risk of Type 2 Diabetes Mellitus: A Population-Based, Nested Case-Control Study in Taiwan [CME]

J Clin Psychiatry 2014;75(1):31-38
10.4088/JCP.13m08421

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.

J Clin Psychiatry 2014;75(1):31–38

Submitted: February 13, 2013; accepted September 4, 2013 (doi:10.4088/JCP.13m08421).

Corresponding author: Susan Shur-Fen Gau, MD, PhD, Department of Psychiatry, National Taiwan University Hospital & College of Medicine, No. 7, Chung-Shan South Rd, Taipei 10002, Taiwan. (gaushufe@ntu.edu.tw).