Antidepressant medication use and risk of hyperglycemia and diabetes mellitus-a noncausal association?

Mika Kivimki, G. David Batty, Markus Jokela, Klaus P. Ebmeier, Jussi Vahtera, Marianna Virtanen, Eric J. Brunner, Adam G. Tabak, Daniel R. Witte, Meena Kumari, Archana Singh-Manoux, Mark Hamer

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Abstract

Background: Previous research suggests a link between antidepressant use and diabetes, but it is unclear whether the association is causal or attributable to detection/ascertainment bias. To examine this, we assessed the associations of antidepressant use with change in glucose levels and incidence of undiagnosed and diagnosed diabetes. Methods: During an 18-year period, we monitored antidepressant use, glucose levels, and diabetes status in 5978 civil servants (70.9% male, age range 3964 years) free of diabetes at baseline (the Whitehall II study). Use of medication and plasma glucose were assessed at four study screenings: 1991/1993, 1997/1999, 2003/2004, and 2008/2009. Incident diabetes cases were classified as either diagnosed (n = 294) if detected using self-report of physician diagnosis and/or the use of diabetes medication or undiagnosed (n = 346) if detected based on fasting and/or 2-hour postload glucose levels using an oral glucose tolerance test at the study screenings. Results: Incidence of diagnosed diabetes was higher among antidepressant users than nonusers (odds ratio 3.10, 95% confidence interval: 1.665.78). However, antidepressant use was not associated with undiagnosed diabetes at any follow-up examination nor with higher fasting or 2-hour postload plasma glucose levels or increasing glucose levels over time. Odds ratio for undiagnosed diabetes for antidepressant users versus nonusers was.88 (95% confidence interval:.451.72, p =.70). The mean difference in glucose changes between participants reporting antidepressant use at three screenings compared with those not on antidepressant treatment was.0 mmol/L. Conclusions: The link between antidepressant use and diabetes risk may not be causal in nature.

Original languageEnglish
Pages (from-to)978-984
Number of pages7
JournalBiological Psychiatry
Volume70
Issue number10
DOIs
Publication statusPublished - Nov 15 2011

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Keywords

  • Antidepressants
  • depression
  • drug toxicity
  • glucose
  • pharmacotherapy
  • type 2 diabetes mellitus

ASJC Scopus subject areas

  • Biological Psychiatry

Cite this

Kivimki, M., Batty, G. D., Jokela, M., Ebmeier, K. P., Vahtera, J., Virtanen, M., Brunner, E. J., Tabak, A. G., Witte, D. R., Kumari, M., Singh-Manoux, A., & Hamer, M. (2011). Antidepressant medication use and risk of hyperglycemia and diabetes mellitus-a noncausal association? Biological Psychiatry, 70(10), 978-984. https://doi.org/10.1016/j.biopsych.2011.07.008