Antidepressant Use Can Improve Diabetes Outcomes in Patients With Depression

Patients with diabetes and depression may have a lower risk of mortality and diabetes complications when taking antidepressants regularly, according to a new study.

Comorbid depression and diabetes can worsen health outcomes in patients; however, regular antidepressant use may lower the risk of death or severe complications. A recent study strived to further understand the linkage between antidepressants and complications and mortality in patients with comorbid depression and diabetes.1

Patients with diabetes are susceptible to a greater risk of depression than the general population. This makes them more likely to have poorer outcomes, such as increased mortality, or develop diabetes-related complications. These complications include heart and kidney disease, stroke, eye, and foot issues.

The study investigators conducted a retrospective cohort study of 36,276 patients with depression and diabetes to find out if antidepressants could improve health outcomes. The findings reveal that regular antidepressant treatment was associated with a lower risk of death and heart disease in patients.1

For the study, the investigators classified antidepressant treatment patterns within a 6-month window into 4 groups: none, poor, partial, and regular use. The investigators accounted for time-dependent variables in the Cox proportional hazards regression analysis with adjustment for time-dependent comorbidity and concomitant use of medications. They compared different classes of antidepressants, using macro- and microvascular complications, as well as all-cause mortality, as the main outcomes. Benzodiazepines were chosen as negative control exposure.2

The regular use of antidepressants was linked to better outcomes compared with poor use of antidepressants:

  • Compared with poor use of antidepressants, the results demonstrated a 0.92-fold decreased risk of macrovascular complications and a 0.86-fold decreased risk of death with regular antidepressant use.
  • Regular use of selective serotonin reuptake inhibitors was associated with a 0.83- and 0.75-fold decreased risk of macrovascular complications and all-cause death, respectively.
  • Regular use of tricyclic or tetracyclic antidepressants was associated with a 0.78-fold decreased risk of all-cause death.
  • For patients taking benzodiazepines, there was no association with diabetes outcomes.

“People with depression and diabetes have poorer health outcomes than those with diabetes alone, and regular antidepressant treatment could lower their risk of complications,” said study author Shi-Heng Wang, PhD, of the China Medical University in Taichung, Taiwan.

According to the study results, it is evident that those who commit to antidepressant treatment have better diabetes outcomes and improved quality of life compared with those with poorer adherence.

The findings of this study show that patients with comorbid diabetes and depression can benefit their overall physical and mental wellbeing with antidepressants. Diabetes complications and mortality rates may be lessened by the implementation of this treatment.12 Clinicians should emphasize antidepressant treatment adherence among patients with depression and diabetes, the investigators concluded.

References

1. Antidepressants may improve outcomes in people with diabetes and depression. Endocrine Society. Press release. Endocrine Society; July 14, 2021. Accessed July 22, 2021. https://www.endocrine.org/news-and-advocacy/news-room/2021/antidepressants-may-improve-outcomes-in-people-with-diabetes-and-depression.

2. Wu C-S, Hsu L-Y, Pan Y-J, Wang S-H. Associations between antidepressant use and advanced diabetes outcomes in patients with depression and diabetes mellitus. The Journal of Clinical Endocrinology & Metabolism. 2021. doi: https://doi.org/10.1210/clinem/dgab443