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Kongress Medizin und Gesellschaft 2007

17. bis 21.09.2007, Augsburg

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Antidepressive agents and the risk of diabetes : a nested case control study using the General Practice Research Database (GPRD)

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  • Frank Andersohn - Bremer Institut für Präventionsforschung und Sozialmedizin (BIPS), Bremen
  • René Schade - Institut für klinische Pharmakologie, Charité - Universitätsmedizin Berlin, Berlin
  • Samy Suissa - McGill Pharmacoepidemiology Research Unit, Division of Clinical Epidemiology, Montreal
  • Edeltraut Garbe - Bremer Institut für Präventionsforschung und Sozialmedizin (BIPS), Bremen

Kongress Medizin und Gesellschaft 2007. Augsburg, 17.-21.09.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. Doc07gmds011

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/gmds2007/07gmds011.shtml

Published: September 6, 2007

© 2007 Andersohn et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Background: Drug-induced weight gain may be associated with metabolic complications typically linked to obesity, such as the development of diabetes mellitus. Whether antidepressants which have been reported to cause significant weight gain also increase the risk of diabetes has not been studied in detail.

Objectives: To assess whether the use of antidepressant drugs is associated with an increase in the risk of diabetes, and to evaluate whether this risk varies according the dose and duration of use.

Methods: Nested case-control study within a cohort of 164805 depressive patients, at least 30 years of age, registered within the UK General Practice Research Database (GPRD) who had at least one new prescription of an antidepressant drug between January 1, 1989 and December 31, 2005. A total of 3916 cases of incident diabetes were identified during follow-up and 15652 controls were matched on age, sex, and year of cohort entry. Rate ratios (RR) of diabetes associated with current use of antidepressants were estimated from odds ratios calculated by conditional logistic regression.

Results: Minor increases in the risk of diabetes associated with current use of antidepressants were observed for drugs acting as combined serotonin and norepinephrine reuptake inhibitors (SNRI; RR=1.22, 95% CI 1.05-1.41), selective serotonin reuptake inhibitors (SSRI; RR=1.14, 95% CI 1.00-1.30), and norepinephrine reuptake inhibitors (NRI; RR=1.37, 95% CI 1.02-1.84). There was no increased risk for the heterogeneous group of other antidepressants (RR=1.09; 95% CI 0.70-1.68). For current users of SNRI and SSRI who had taken these drugs more than 2 years in daily doses greater than the defined daily dose (DDD), the risks were 2.84 (95% CI 1.18-6.87) and 1.89 (95% CI 1.28-2.79), respectively.

Conclusions: Antidepressant use in general was not associated with a marked risk of diabetes. However, the risk may increase with prolonged use of SNRI and SSRI at high daily doses.