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- Title
Associations Between Antidepressant Use and Advanced Diabetes Outcomes in Patients with Depression and Diabetes Mellitus.
- Authors
Chi-Shin Wu; Le-Yin Hsu; Yi-Jiun Pan; Shi-Heng Wang; Wu, Chi-Shin; Hsu, Le-Yin; Pan, Yi-Jiun; Wang, Shi-Heng
- Abstract
<bold>Context: </bold>Comorbid depression in patients with diabetes deteriorates the prognosis. Antidepressants might attenuate the adverse effects of depression; however, they are associated with cardiometabolic adverse effects.<bold>Objective: </bold>This study aimed to explore the association between antidepressant treatment and advanced diabetic complications and mortality among patients with depression and diabetes mellitus.<bold>Methods: </bold>We conducted a nationwide retrospective cohort study of 36 276 patients with depression and newly treated diabetes mellitus using Taiwan's universal health insurance database. Antidepressant treatment patterns within a 6-month window were classified into none, poor, partial, and regular use, and we accounted for time-dependent variables in the Cox proportional hazards regression analysis with adjustment for time-dependent comorbidity and concomitant use of medications. Different classes of antidepressants were compared. Macro- and microvascular complications, as well as all-cause mortality, were the main outcomes. Benzodiazepines were chosen as negative control exposure.<bold>Results: </bold>Compared with poor use of antidepressants, regular use was associated with a 0.92-fold decreased risk of macrovascular complications and a 0.86-fold decreased risk of all-cause mortality but not associated with microvascular complications. Regular use of selective serotonin reuptake inhibitors was associated with a 0.83- and 0.75-fold decreased risk of macrovascular complications and all-cause mortality, respectively. Regular use of tricyclic or tetracyclic antidepressants was associated with a 0.78-fold decreased risk of all-cause mortality. Regular use of benzodiazepine showed no association with diabetic outcomes.<bold>Conclusion: </bold>Regular antidepressant use was associated with lower risk of advanced diabetic complications compared with poor adherence. Clinicians should emphasize antidepressant treatment adherence among patients with depression and diabetes mellitus.
- Subjects
ANTIDEPRESSANTS; DIABETES; HEALTH outcome assessment
- Publication
Journal of Clinical Endocrinology & Metabolism, 2021, Vol 106, Issue 12, pe5136
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/clinem/dgab443