Antidepressant Medication as a Risk Factor for Type 2 Diabetes and Impaired Glucose Regulation Systematic review

被引:117
作者
Barnard, Katharine [1 ]
Peveler, Robert C. [2 ]
Holt, Richard I. G. [1 ]
机构
[1] Univ Southampton, Fac Med, Human Dev & Hlth Acad Unit, Southampton SO9 5NH, Hants, England
[2] Univ Southampton, Fac Med, Clin & Expt Sci Acad Unit, Southampton SO9 5NH, Hants, England
关键词
DEPRESSIVE SYMPTOMS; MEDICINE USE; MELLITUS; ASSOCIATION; DIAGNOSIS; WEIGHT;
D O I
10.2337/dc13-0560
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVEAntidepressant use has risen sharply over recent years. Recent concerns that antidepressants may adversely affect glucose metabolism require investigation. Our aim was to assess the risk of type 2 diabetes associated with antidepressants through a systematic review.RESEARCH DESIGN AND METHODSData sources were MEDLINE, Embase, PsycINFO, The Cochrane Library, Web of Science, meeting abstracts of the European Association for the Study of Diabetes, American Diabetes Association, and Diabetes UK, Current Controlled Trials, ClinicalTrials.gov, U.K. Clinical Research Network, scrutiny of bibliographies of retrieved articles, and contact with relevant experts. Relevant studies of antidepressant effects were included. Key outcomes were diabetes incidence and change in blood glucose (fasting and random).RESULTSThree systemic reviews and 22 studies met the inclusion criteria. Research designs included 1 case series and 21 observational studies comprising 4 cross-sectional, 5 case-control, and 12 cohort studies. There was evidence that antidepressant use is associated with type 2 diabetes. Causality is not established, but rather, the picture is confused, with some antidepressants linked to worsening glucose control, particularly with higher doses and longer duration, others linked with improved control, and yet more with mixed results. The more recent, larger studies, however, suggest a modest effect. Study quality was variable.CONCLUSIONSAlthough evidence exists that antidepressant use may be an independent risk factor for type 2 diabetes, long-term prospective studies of the effects of individual antidepressants rather than class effects are required. Heightened alertness to potential risks is necessary until these are complete.
引用
收藏
页码:3337 / 3345
页数:9
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