Antidepressant use may help bring on diabetes.(Clinical Rounds)

WASHINGTON -- Frequent antidepressant use may be associated with the development of type 2 diabetes, according to a post hoc subanalysis of patients in the randomized Diabetes Prevention Program trial.

This is the first reported instance of an increased risk of diabetes associated with antidepressant use.

Richard R. Rubin, Ph.D., and his coinvestigators found a 2.2- to 3.2-fold increased risk of diabetes among patients in the placebo and intensive diet and exercise intervention arms of the trial, but not in the third group of patients who received metformin. The researchers' analysis centered on 3,187 patients with impaired glucose tolerance and elevated fasting blood glucose levels who completed the Beck Depression Inventory and reported antidepressant use.

This finding "has some very profound public health implications," because about 40 million people in the United States have prediabetic conditions, such as impaired glucose tolerance, and 10%-15% of Americans are taking antidepressants, Dr. Rubin said during a press conference at the annual scientific sessions of the American Diabetes Association.

Yet, the post hoc analysis "raises more questions than it answers," such as why antidepressants might have this effect, whether particular antidepressants have this effect and others do not, why metformin users did not have an increased risk of diabetes, and whether the effect applies only to people with prediabetes, said Dr. Rubin, incoming president of the ADA.

At the beginning of the study, 10.3% of the patients had elevated depressive symptoms (a score of 11 or greater on ...