Type of antidepressant therapy and risk of type 2 diabetes in people with depression

Objective: The objective of this study was to evaluate the differential risk of diabetes among people with depression taking antidepressant therapy. Methods: A nested case control design was used to investigate the study objective. Data from the Canadian province of Saskatchewan was available from January 1, 1991 to December 31, 2001; the average length of follow-up was 4.07 years. Type 2 diabetes was identified based on ICD-9 diagnostic codes and antidiabetic medication prescriptions; prior depression was ascertained based on ICD-9 diagnostic codes and antidepressant prescriptions. Results: Multivariate logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence intervals (CI). We identified 2391 individuals with incident depression treated with antidepressant therapy. The mean age was 53.6 (S.D.: 16.4) and 68% were female. After multivariate adjustment, the concurrent use of selective serotonin reuptake inhibitors (SSRI) and tricyclic antidepressants (TCA) was associated with a significantly increased risk of type 2 diabetes (adjusted OR: 1.89; 95% CI: 1.35-2.65). Conclusions: Concurrent use of TCA and SSRI was associated with an increased risk of developing type 2 diabetes compared to using TCA alone. Individuals taking combination TCA and SSRI therapy should be closely monitored for development of type 2 diabetes. (c) 2007 Elsevier Ireland Ltd. All rights reserved.