Antidepressants for depressed patients with type 2 diabetes mellitus: A systematic review and network meta-analysis of short-term randomized controlled trials

This network meta-analysis compared the short-term treatment effects of different antidepressants on depression severity and HbA1c in depressed patients with type 2 diabetes mellitus (T2DM). We searched 8-to 24-week randomized-controlled trials (RCTs) in PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, and Clinicaltrials.gov on November 22, 2021. We included 12 RCTs (N = 792) studying agomelatine, citalopram, escitalopram, fluoxetine, nortriptyline, no treatment, paroxetine, sertraline, vortioxetine, and placebo. Compared to placebo, the standardized mean differences and 95% confidence intervals (SMD, 95%CIs) for depression severity reduction revealed that escitalopram ranked first (-2.93,-3.92 to-1.94), followed by agomelatine (-0.68,-1.15 to-0.20). Compared to placebo, the mean differences (MDs, 95%CIs) for HbA1c reduction suggested that vortioxetine ranked first (-2.35,-4.13 to-0.57), followed by escitalopram (-1.00,-1.42 to-0.57) and agomelatine (-0.79,-1.16 to-0.42). Limited evidence from short-term trials in depressed patients with T2DM suggests that escitalopram and agomelatine may have a favorable profile in reducing depression and controlling glycemic goals, but more trials are required.

Automated summary

This network meta-analysis compared the short-term treatment effects of different antidepressants on depression severity and HbA1c in depressed patients with type 2 diabetes mellitus. The results showed that escitalopram ranked first in reducing depression severity and HbA1c, followed by agomelatine.