The change of insulin levels after six weeks antidepressant use in drug-naive major depressive patients

Background: A reciprocal relationship between diabetes risk and depression has been reported. There are few studies investigating glucose insulin homeostasis before and after short-term antidepressant treatment in drug naive major depressive disorder (MDD) patients. Methods: This study included 104 healthy controls and 50 drug naive MDD patients diagnosed according to the DSM-IV criteria. These MDD patients were randomly assigned to receive fluoxetine or venlafaxine for six weeks. Depressive symptoms, body mass index, fasting plasma levels of glucose and insulin were measured. Results: Compared to the healthy controls, the fasting plasma insulin and the homeostasis model of assessment for pancreatic beta-cell secretory function (HOMA-beta) was significantly lower in the MDD patients before antidepressant treatment (7.7 +/- 4.8 vs. mu IU/mL vs. 5.1 +/- 4.2 mu IU/mL, p=0.006; 114.2 +/- 72.3% vs. 74.8 +/- 52.0%, p=0.005, respectively). However, these indices were not correlated with depression severity. After 6 weeks of fluoxetine or venlafaxine treatment, the level of HOMA-beta borderline significantly increased (108.1 +/- 75.5%, p=0.059). Limitations: The study was limited by the follow-up duration and lack of a placebo group. Conclusions: Antidepressants might affect insulin secretion independently of the therapeutic effects On MDD. Further studies are needed to investigate the long-term effects of antidepressants On insulin regulation in MDD patients. (C) 2013 Elsevier B.V. All rights reserved.