A recently published Japanese study explored associations between new-onset type 2 diabetes and duration of antidepressant use/antidepressant dose, as well as the effects of antidepressant use after diabetes onset and the effects upon clinical outcomes.The design employed was a large retrospective cohort study examining 45265 new antidepressant users (exposure ) and an equal number of non-users (non-exposure ), aged 20–79 year. Those with with a history of diabetes or treatment with drugs used for the treatment of diabetes were excluded. Co-variates were adjusted by using propensity score matching. Changes in glycated hemoglobin (HbA1c) level were examined for groups where there was continuous antidepressant use, discontinuation, or a reduction in the dose of antidepressant.
5,225 subjects (5.8%) developed diabetes, and antidepressant use was associated with the risk of diabetes onset in a time- and dose-dependent manner. The adjusted hazard ratio was 1.27 (95% CI 1.16–1.39) for short-term low-dose antidepressant use, and 3.95 (95% CI 3.31–4.72) for long-term high-dose antidepressant use. HbA1c levels were lower in patients who discontinued or reduced the dose of antidepressants (P < 0.001). The results of this study should not preclude the use of antidepressants where clinically indicated, but do suggest that careful monitoring and targeted adjustment of treatment is worthwhile. See more here