Antidepressant Medication Use, Weight Gain, and Risk of Type 2 Diabetes A population-based study

OBJECTIVE - To examine antidepressant medication use as a risk factor for type 2 diabetes and weight gain RESEARCH DESIGN AND METHODS - A series of nested studies within a prospective cohort of 151 347 working aged men and women including 9 197 participants with continuing antidepressant medication 224 with severe depression and 851 with incident type 2 diabetes during a mean follow-up of 4 8 years as indicated by national health and prescription registers (the Public Sector study Finland 1995-2005) RESULTS - In the first analysis the case subjects were individuals with incident type 2 diabetes compared with matched diabetes-free control subjects Antidepressant use of >= 200 defined daily doses was associated with a doubling of diabetes risk in both participants with no indication of severe depression (odds ratio 1 93 [95% CI 1 48-2 51]) and participants with severe depression (2 65 [1 31-5 39]) In further analyses the exposed group was antidepressant users and the reference group was nonusers matched for depression related characteristics The 5-year absolute risk of diabetes was 1 1% for nonusers 1 7% for individuals treated with 200-399 defined daily doses a year and 2 3% for those with >= 400 defined daily doses (P-trend < 0 0001) An average self-reported weight gain be sed on repeated surveys was 1 4 kg (2 5%) among nonusers and 2 5 kg (4 3%) among users >= 200 defined daily doses (P-trend < 0 0001) Separate analyses for tricyclic antidepressants and selective serotonin reuptake inhibitors replicated these findings CONCLUSIONS - In these data continuing use of antidepressant medication was associated with an increased relative risk of type 2 diabetics although the elevation in absolute risk was modest