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, A. Tabák, 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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Hyperglycemia
Antidepressive Agents
Diabetes Mellitus
Glucose
Fasting
Odds Ratio
Confidence Intervals
Incidence
Glucose Tolerance Test
Self Report
Physicians
Research

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., ... 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

Antidepressant medication use and risk of hyperglycemia and diabetes mellitus-a noncausal association? / Kivimki, Mika; Batty, G. David; Jokela, Markus; Ebmeier, Klaus P.; Vahtera, Jussi; Virtanen, Marianna; Brunner, Eric J.; Tabák, A.; Witte, Daniel R.; Kumari, Meena; Singh-Manoux, Archana; Hamer, Mark.

In: Biological Psychiatry, Vol. 70, No. 10, 15.11.2011, p. 978-984.

Research output: Contribution to journalArticle

Kivimki, M, Batty, GD, Jokela, M, Ebmeier, KP, Vahtera, J, Virtanen, M, Brunner, EJ, Tabák, A, Witte, DR, Kumari, M, Singh-Manoux, A & Hamer, M 2011, 'Antidepressant medication use and risk of hyperglycemia and diabetes mellitus-a noncausal association?', Biological Psychiatry, vol. 70, no. 10, pp. 978-984. https://doi.org/10.1016/j.biopsych.2011.07.008
Kivimki, Mika ; Batty, G. David ; Jokela, Markus ; Ebmeier, Klaus P. ; Vahtera, Jussi ; Virtanen, Marianna ; Brunner, Eric J. ; Tabák, A. ; Witte, Daniel R. ; Kumari, Meena ; Singh-Manoux, Archana ; Hamer, Mark. / Antidepressant medication use and risk of hyperglycemia and diabetes mellitus-a noncausal association?. In: Biological Psychiatry. 2011 ; Vol. 70, No. 10. pp. 978-984.
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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.",
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AU - Virtanen, Marianna

AU - Brunner, Eric J.

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N2 - 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.

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