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Effects of antidepressants on glucose metabolism and diabetes mellitus type 2 in adults

Deuschle, Michael

Current Opinion in Psychiatry: January 2013 - Volume 26 - Issue 1 - p 60–65
doi: 10.1097/YCO.0b013e32835a4206
MOOD AND ANXIETY DISORDERS: Edited by Cornelius Katona and Gordon Parker

Purpose of review Depression and diabetes mellitus type 2 (DM2) are frequently comorbid conditions. It is of considerable clinical significance to avoid metabolic risks in nondiabetic depressed patients and to consider effects on glucose regulation in depressed DM2 patients. This review is an overview on antidepressant treatment and its potential metabolic risks.

Recent findings It is increasingly recognized that effective treatment with antidepressants improves glucose homeostasis in nondiabetic depressed patients in the short run, whereas long-term effects are a matter of debate. Cognitive behavioral and selective serotonin reuptake inhibitor (SSRI) treatment may improve glycemic control in depressed DM2 patients, whereas noradrenergic antidepressants and tricyclic antidepressants (TCAs) may cause the metabolic situation to deteriorate.

Summary SSRIs are preferable in nondiabetic depressed patients since they improve glucose regulation in the short run and may have little untoward effects in the long run. In depressed DM2 patients, SSRIs are the only class of antidepressants with confirmed favorable effects on glycemic control.

Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Germany

Correspondence to Professor Dr Michael Deuschle, Zentralinstitut für Seelische Gesundheit, J5, 68159 Mannheim, Germany. Tel: +49 621 1703 2331; fax: +49 621 1703 2325; e-mail: michael.deuschle@zi-mannheim.de

© 2013 Lippincott Williams & Wilkins, Inc.