The use of most types of antidepressants (ATDs) is associated with significantly reduced mortality among patients with diabetes mellitus (DM) and comorbid depression, a study published online in the Journal of Clinical Endocrinology & Metabolism has found.
Hong-Ming Chen, MD, from the Chiayi Chang Gung Memorial Hospital in Chiayi, Taiwan, and colleagues conducted a retrospective cohort study using the National Health Insurance Research Database in Taiwan. Since 2000, the authors identified 53,412 patients with newly diagnosed DM and depression, who were followed until 2013 to assess mortality.
Using a time-dependent Cox regression model, the researchers found that use of ATDs was associated with significantly reduced mortality (hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.59 to 0.71). The reductions in mortality risk differed across categories of ATDs: selective serotonin reuptake inhibitors (HR, 0.63; 95% CI, 0.56 to 0.71), serotonin-norepinephrine reuptake inhibitors (HR, 0.58; 95% CI, 0.44 to 0.78), norepinephrine-dopamine reuptake inhibitors (HR, 0.20; 95% CI, 0.07 to 0.63), mirtazapine (HR, 0.60; 95% CI, 0.45 to 0.82), tricyclic/tetracyclic antidepressants (HR, 0.73; 95% CI, 0.54 to 0.97), and trazodone (HR, 0.52; 95% CI, 0.29 to 0.91). In contrast to other ATDs, reversible inhibitors of monoamine oxidase A (RIMA) were associated with an increase in total mortality risk (HR, 1.48; 95% CI, 1.09 to 1.99).
“To our knowledge, this is the first large population-based cohort study to identify an inverse association between ATD use and mortality among individuals diagnosed with DM and comorbid depression,” write the authors.
REFERENCE: Chen et al: Antidepressants reduced risk of mortality in patients with diabetes mellitus: a population-based cohort study in Taiwan. J Clin Endocrinol Metab jc.2018-02362. https://academic.oup.com/jcem/advance-article-abstract/doi/10.1210/jc.2018-02362/5526757