Antidepressants Tied to Lower Death Risk in Diabetes Patients With Depression

By Anne Harding

NEW YORK (Reuters Health) - Antidepressants are associated with a 35% reduced risk of mortality in patients with diabetes mellitus (DM) and depression, a retrospective study suggests.

"This data provides further rationale for the screening and treating of depression in persons with DM," Dr. Vincent Chin-Hung Chen of Chang Gung Medical University in Taiwan, the study's senior author, told Reuters Health in an email.

DM patients are at increased risk of major depressive disorder, and each condition contributes independently to increased mortality, Dr. Chen and his team note in their July 2 report in the Journal of Clinical Endocrinology & Metabolism.

They looked at 53,412 patients with preexisting DM who were diagnosed with depression after 2000 using the Taiwan National Health Insurance Research Database, including 50,532 individuals on antidepressants. Patients were followed through 2013, or at death.

Patients on antidepressants were younger, more urban and of higher socioeconomic status, on average. As total cumulative antidepressant dose exposure rose, mortality fell. The effect became statistically significant at a cumulative defined daily dose (cDDD) above 28 (hazard ratio 0.91). With cDDD of 84 or higher, mortality was 35% lower (HR 0.65).

Looking at ATDs separately, the authors found significantly reduced mortality with most drugs at cDDD 84 and above: selective serotonin receptor inhibitors, HR 0.63; selective norepinephrine receptor inhibitors, HR 0.20; mirtazapine, HR 0.60; tricyclic/tetracyclic antidepressants, HR 0.73; and trazodone, HR 0.52. However, mortality was higher with both low (HR 1.91) and high doses (HR 1.48) of reversible inhibitors of monoamine oxidase A.

"Database research is an association study and does not represent a causal relationship. The results should be interpreted with caution," Dr. Chen said. "Further replication studies, especially from different countries, are warranted. We also need more direct clinical evidence and basic research to confirm this effect."

SOURCE: https://bit.ly/2xAsU0X

J Clin Endocrinol Metab 2019.

(c) Copyright Thomson Reuters 2019. Click For Restrictions - https://agency.reuters.com/en/copyright.html
Source: