Prescribing antidepressants to people with comorbid diabetes and depression lowered mortality by 35%, according to a study published online in The Journal of Clinical Endocrinology & Metabolism.
While the US Centers for Disease Control and Prevention warns that patients with diabetes are 2 to 3 times more likely to have depression than people without diabetes, up to three quarters of those with diabetes and depression go undiagnosed.
“The incidence of major depressive disorder among individuals with diabetes is significantly greater than the general population,” said study corresponding author Vincent Chin-Hung Chen, MD, PhD, a professor at Chiayi Chang Gung Memorial Hospital and Chang Gung University in Puzi, Taiwan. “Diabetes and depression each independently contribute to increasing total mortality.”
The retrospective, population-based study followed 53,412 patients in Taiwan diagnosed with diabetes and depression between 2000 and 2013 to gauge how antidepressant use affected death rates. Researchers found antidepressant use in the patient population significantly reduced mortality.
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Hazard ratios for specific antidepressant categories were 0.63 for selective serotonin reuptake inhibitors, 0.58 for serotonin-norepinephrine reuptake inhibitors; 0.20 for norepinephrine-dopamine reuptake inhibitors, 0.60 for mirtazapine, 0.73 for tricyclic/tetracyclic antidepressants, and 0.52 for trazodone.
Contrary to the effect of other antidepressants, reversible inhibitors of monoamine oxidase A (RIMAs) were associated with an increase in total mortality, the study found. Researchers identified a hazard ratio of 1.48 for RIMAs.
They concluded that most antidepressants, aside from RIMAs, are linked with significantly reduced risk of mortality in patients with comorbid diabetes and depression.
“This data provides further rationale for the screening and treating of depression in persons who have diabetes,” Dr. Chen said.
Chen HM, Yang YH, Chen KJ, et al. Antidepressants reduced risk of mortality in patients with diabetes mellitus: a population-based cohort study in Taiwan. The Journal of Clinical Endocrinology & Metabolism. 2019 July 2;[Epub ahead of print].