First of Its Kind Study of Antidepressant Use in Comorbid Depression and Type 2 Diabetes Mellitus

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Although treatment guidelines do not provide specific prescribing recommendations for antidepressants in individuals with diabetes, effective treatment of depression in individuals with comorbid depression and type 2 diabetes mellitus is important for both conditions.

In a first of its kind study looking at the prevalence of antidepressant prescribing and associated patient characteristics, as well as recognize safety issues, Jeffrey et al¹ searched 7 databases using terms related to depression, type 2 diabetes mellitus, and antidepressant medication. From the 9 utilized reports, it was determined that the prevalence of antidepressant prescribing varied considerably between studies from 18% to 87%.

“This review has highlighted the gap in our knowledge about which antidepressant agents are being used in adults with comorbid depression and [type 2 diabetes mellitus], and alongside which concurrent medications and comorbidities. Thus, we are unaware of the extent to which such individuals are at risk from the risks associated with polypharmacy and other adverse effects,” wrote the study authors.¹

Investigators also found women with type 2 diabetes mellitus are more likely to be prescribed antidepressants compared to men; however, the difference is less than in the general population. Additionally, individuals with more advanced type 2 diabetes mellitus who use insulin were as likely to be prescribed antidepressants as those who did not use insulin.

“This is the first systematic review to our knowledge that investigates the prevalence and characteristics of antidepressant prescribing in adults with comorbid depression and [type 2 diabetes mellitus],” the study authors said. They added that, “There is an urgent need for longitudinal studies to inform guidelines on the long-term safety and effectiveness of antidepressant prescription in persons with comorbid depression and [type 2 diabetes mellitus].”¹

With a lack of evidence to support the long term use of antidepressants in individuals with type 2 diabetes mellitus, special care should be taken when prescribing antidepressants—especially in more complex patients, who have higher risks of potential adverse events.

Reference

1. Jeffrey A, Maconick L, Francis E, et al. Prevalence and characteristics of antidepressant prescribing in adults with comorbid depression and type 2 diabetes mellitus: a systematic review and meta-analysis. Health Sci Rev (Oxf). 2021;1.