All concepts, explanations, trials, and studies have been re-written in plain English and may contain errors. I am not a doctor ----------------------------------------------------------- NOTE: You can make the print bigger with the font button on your browser! (It's usually a big "A") ----------------------------------------------------------- Antidepressants linked to increased type 2 diabetes risk June 13, 2006 - A new study links antidepressant use to a tripled risk of type 2 diabetes in people with risk factors for diabetes. Researchers studied data on patients already in the Diabetes Prevention Program (DPP) who were taking antidepressant drugs at the study's start or who took them frequently during the study. Such patients were 2 to 3 times more likely to develop diabetes. With more than 10 million Americans taking antidepressant drugs, and many at risk for diabetes due to poor diet and being too fat, this is a potential national nightmare. The DPP trial began in 1997 and is designed to test if diabetes can be prevented or delayed in high-risk people through serious life style changes or metformin (Glucophage) use versus placebo. We've known for years that depression and type 2 diabetes are linked but how or why is unknown. These researchers used scores from what is called the "Beck Depression Inventory" or BDI to measure depression and antidepressant use. 3,187 patients in the DPP were studied. They were 25 years or older with reduced blood sugar tolerance, high fasting blood sugar, and a body-mass index (BMI) higher than 24 kg/m2. Three groups were chosen : 1) The placebo group got standard life style recommendations plus a placebo pill twice daily. 2) The metformin group had standard life style recommendations plus 850mg metformin twice daily. 3) The third group had intense life style changes and were supported in losing at least 7% of their initial body weight and keeping that weight off through a calorie-controlled, low-fat diet. They had to engage in physical activity of moderate intensity for at least 150 minutes per week. Diabetes status, depression symptoms, physical activity levels, insulin secretion, and insulin resistance were all measured before and once a year during the study. Antidepressant use was checked at study start and then 4 times a year. At study start, 10% of patients were depressed (Beck's Depression Inventory score greater than 11). Five percent were taking an antidepressant. Strangely, depression at study start did not predict development of diabetes, but antidepressant drug use did. So, actually being depressed or getting depressed during the trial did not increase risk for diabetes. However, taking an antidepressant drug greatly increased risk of getting diabetes UNLESS you were in the metformin group. Diabetes risk was twice as much for placebo patients on antidepressants and 3-1/2 times as much for life style change patients taking anti-depressants. One big surprise was that metformin patients taking anti-depressants had no increase in risk of diabetes. No one knows why yet. Another tidbit is that patients who only took their anti-depressants 75% of the time or less did not have increased risk of diabetes. Those who took it at least 88% of the time did increase their risk of diabetes. This did not apply to the metformin group. If patients at high risk for type 2 diabetes get depressed, doctors should consider counseling and life style changes before prescribing anti-depressant drugs. The effect of metformin in patients at high risk for diabetes but who do not yet have it also needs to be discovered. Source: American Diabetes Association 2006 Scientific Sessions; June 9-13, 2006 ; Washington, DC. Abstract 896-P. Title: Depression symptoms, antidepressant medication use, and risk of developing diabetes in Diabetes Prevention Program participants. Authors: Drs Richard Rubin and David Marrero.