Long-term antidepressant use and the risk of type 2 diabetes mellitus: a population-based, nested case-control study in Taiwan

J Clin Psychiatry. 2014 Jan;75(1):31-8; quiz 38. doi: 10.4088/JCP.13m08421.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Antidepressive Agents / adverse effects*
  • Case-Control Studies
  • Diabetes Mellitus, Type 2 / chemically induced*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Humans
  • Middle Aged
  • Odds Ratio
  • Registries*
  • Risk
  • Selective Serotonin Reuptake Inhibitors / adverse effects*
  • Serotonin Antagonists / adverse effects*
  • Taiwan / epidemiology
  • Time Factors
  • Young Adult

Substances

  • Antidepressive Agents
  • Serotonin Antagonists
  • Serotonin Uptake Inhibitors