Classes of antidepressant medications and associations with type 2 diabetes: a systematic review Restricted; Files Only

Sharma, Anuja (Summer 2019)

Permanent URL: https://etd.library.emory.edu/concern/etds/1c18dg86j?locale=en
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Abstract

Introduction: Antidepressant use has increased over recent years. Some studies suggest that antidepressants may affect glucose metabolism and that the associations of antidepressants to glucose metabolism may be modified by class of drug. Our aim was to systematically assess specific classes of antidepressant medication for potential variation in longitudinal risk of type 2 diabetes.

Methods: A systematic literature search for longitudinal studies examining antidepressant classes was conducted on PubMed. Our search was restricted to papers published from 1990 to 2018 and only included studies assessing the incidence of new-onset diabetes or changes in blood glucose, HbA1c or insulin levels in adult subjects with unipolar depression treated with antidepressants. Our search was restricted to English language studies having a sample size ≥ 30.

Results: Eight studies published between 2007 and 2016 met our inclusion criteria. Research designs included 4 cohort studies, 3 case-control studies and 1 case series. A significant increase in risk of developing type 2 diabetes was reported across medication classes (Selective Serotonin Reuptake Inhibitor: 3/7, Tricyclic antidepressant: 3/6, concurrent use of Selective Serotonin Reuptake Inhibitor and Tricyclic antidepressant: 1/1, Serotonin and Norepinephrine Reuptake Inhibitor: 1/1 and Tetracyclic antidepressant: 1/1).

Conclusion: Longitudinal evidence from the past 25 years suggests that antidepressant class may impact glucose dysregulation and the risk of developing type 2 diabetes differentially. Given the possible heterogeneity of different antidepressants on the association with blood glucose levels, we suggest future studies classify the risk of type 2 diabetes according to antidepressant class, dosage, and duration of use. Future studies that formally evaluate the risks and benefits of prescribing specific antidepressants should include potential impacts of diabetes risk.

Table of Contents

List of Abbreviations…………………………………………………………………….9

Chapter 1

Review of Literature…………………………………………………………………….10

Chapter 2

Abstract……………………………………………………………………………………22

Introduction……………………………………………………………………………...23

Methods…………………………………………………………………………………...24

Results……………………………………………………………………………………..26

Discussion…………………………………………………………………………………33

Tables and Figures……………………………………………………………………….39

References………………………………………………………………….……………..49

Chapter 3

Public Health Implications…………………………………………………………….54

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