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Diabetes

Most antidepressants reduce mortality for patients with diabetes and depression

Research has shown that people with diabetes who take the highest dose of certain antidepressants have a reduced mortality rate compared with patients taking the lowest dose.

Mirtazapine packet

Source: GeoPic / Alamy Stock Photo

In the highest dose group, mirtazapine was associated with a 40% reduction in risk of mortality, compared with those in the lowest dose group 

Use of certain antidepressants in patients with diabetes is associated with a reduction in mortality, according to a results of a population-based study (2 July 2019)[1].

Researchers used the National Health Insurance Research Database in Taiwan to identify 53,412 patients diagnosed with diabetes and depression since 2000. Of these, 50,532 (95%) were prescribed antidepressants, of which the researchers recorded the type and dose alongside mortality data up to 2013.

Each antidepressant category was divided into three groups according to cumulative dose exposure and risk of mortality was then evaluated by comparing the highest dose group with the lowest dose group. 

In the highest dose group, it was found that antidepressant use was linked to a 35% reduction in risk of mortality compared with the lowest dose group. 

The effect varied across antidepressant classes: norepinephrine-dopamine reuptake inhibitors reduced mortality risk by 80%; trazadone reduced mortality risk by 48% and serotonin-norepinephrine reuptake inhibitors reduced mortality risk by 41%.

Mirtazapine, selective serotonin reuptake inhibitors and tricyclic/tetracyclic antidepressants reduced risk of mortality by 40%, 36% and 27%, respectively.

In contrast, reversible inhibitors of monoamine oxidase A were associated with a 48% increased risk of mortality.

“[These] data provide further rationale for the screening and treating of depression in persons who have diabetes,” said study author Vincent Chin-Hung Chen, a researcher in pharmacy, psychiatry and addiction medicine at the Chiayi Chang Gung Memorial Hospital in Taiwan.

Citation: Clinical Pharmacist DOI: 10.1211/CP.2019.20206881

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