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Antidepressants and risk of DM/Metabolic Abnormalities

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Antidepressants and risk of DM/Metabolic Abnormalities

Post  Admin on Sat Jul 06, 2013 7:08 pm


Can someone post a good article on risk of DM/Metabolic syndrome with Antidepressants, and also individual risk comparison of each antidepressant.

Thanks.

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Re: Antidepressants and risk of DM/Metabolic Abnormalities

Post  P450 on Sun Jul 21, 2013 12:13 am

I have two. The first is about weight gain and compares ADs. The second is specifically about DM and ADs, and it also compares ADs.
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J Clin Psychiatry. 2010 Oct;71(10):1259-72. doi: 10.4088/JCP.09r05346blu.
Antidepressants and body weight: a comprehensive review and meta-analysis.

Abstract
OBJECTIVE:

Psychotropic drugs often induce weight gain, leading to discomfort and discontinuation of treatment and, more importantly, increasing the risk of obesity-related illnesses such as diabetes mellitus, hypertension, and coronary heart disease. There is evidence that antidepressant drugs may induce a variable amount of weight gain, but results are sparse and often contradictory.
DATA SOURCES:

We performed a literature search using the MEDLINE, ISI Web of Knowledge, and Cochrane research databases for all publications available to January 2009. We used the following keywords: antidepressant, psychotropic drugs, body weight, weight gain, obesity, overweight, adverse event, side effects, SSRIs, tricyclic antidepressants, and the name of each antidepressant active compound together with body weight or other keywords. Studies reporting body weight changes during treatment with different antidepressants were selected for eligibility. Finally, 116 studies were included in the analysis.
DATA EXTRACTION:

Weight change mean and standard deviation and size of each group were recorded. Missing means and standard deviations were directly calculated by using information available in the article when possible. Non-placebo-controlled studies were compared to a virtual placebo sample, whose mean and standard deviation were derived by the weighted mean of means and standard deviations of all placebo samples. Methodological quality of studies, heterogeneity, publication bias, and effect of treatment duration were systematically controlled.
DATA SYNTHESIS:

Quantitative results evidenced that amitriptyline, mirtazapine, and paroxetine were associated with a greater risk of weight gain. In contrast, some weight loss occurs with fluoxetine and bupropion, although the effect of fluoxetine appears to be limited to the acute phase of treatment. Other compounds have no transient or negligible effect on body weight in the short term. However, the effect of each antidepressant may vary greatly depending on an individual's characteristics and generally became more evident in the long term to a variable degree across compounds.
CONCLUSIONS:

Despite the fact that some analyses were done on only a few studies due to the difficulty of finding reliable information in literature, to our knowledge, this is the first comprehensive meta-analysis to allow comparison of different antidepressants as regards their impact on body weight. Data presented may be helpful for a more accurate treatment selection in patients at risk of obesity or related medical illness.
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Am J Psychiatry. 2009 May;166(5):591-8. doi: 10.1176/appi.ajp.2008.08071065. Epub 2009 Apr 1.
Long-term use of antidepressants for depressive disorders and the risk of diabetes mellitus.
Andersohn F, Schade R, Suissa S, Garbe E.
Source

Bremen Institute for Prevention Research and Social Medicine, Bremen, Germany. frank.andersohn@charite.de
Abstract
OBJECTIVE:

Use of antidepressants has been reported to cause considerable weight gain. The aim of this study was to assess the risk of diabetes mellitus associated with antidepressant treatment and to examine whether the risk is influenced by treatment duration or daily dose.
METHOD:

This was a nested case-control study in a cohort of 165,958 patients with depression who received at least one new prescription for an antidepressant between January 1, 1990, and June 30, 2005. Data were from from the U.K. General Practice Research Database. Patients were at least 30 years of age and without diabetes at cohort entry.
RESULTS:

A total of 2,243 cases of incident diabetes mellitus and 8,963 matched comparison subjects were identified. Compared with no use of antidepressants during the past 2 years, recent long-term use (>24 months) of antidepressants in moderate to high daily doses was associated with an increased risk of diabetes (incidence rate ratio=1.84, 95% CI=1.35-2.52). The magnitude of the risk was similar for long-term use of moderate to high daily doses of tricyclic antidepressants (incidence rate ratio=1.77, 95% CI=1.21-2.59) and selective serotonin reuptake inhibitors (incidence rate ratio=2.06, 95% CI=1.20-3.52). Treatment for shorter periods or with lower daily doses was not associated with an increased risk.
CONCLUSIONS:

Long-term use of antidepressants in at least moderate daily doses was associated with an increased risk of diabetes. This association was observed for both tricyclic antidepressants and selective serotonin reuptake inhibitors.

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Re: Antidepressants and risk of DM/Metabolic Abnormalities

Post  Admin on Sun Jul 21, 2013 6:52 pm

Thanks Goodluck 

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