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Li R, Fu R, Yang WM, Cui ZQ, Liang XJ, Yang JB, Liu L, Tan QR, Peng ZW. Acute treatment of bilateral rTMS combined with antidepressants on the plasma fatty acids for major depressive episodes. Brain Res 2024; 1843:149125. [PMID: 39025398 DOI: 10.1016/j.brainres.2024.149125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 07/08/2024] [Accepted: 07/15/2024] [Indexed: 07/20/2024]
Abstract
Bilateral repetitive transcranial magnetic stimulation (B-rTMS) has been largely used in the treatment of major depressive disorder (MDD). Nonetheless, information on the acute treatment by B-rTMS combined with antidepressants (ADs) on the plasma fatty acids in MDD is limited. The present study focused on depressive symptoms; Plasma was obtained from 27 adult patients with MDD at baselinephase (MDD), after 2 weeks of treatment (MDD-2w), and 27 healthy controls (HC). Meanwhile, we evaluated the composition of short-chain fatty acids (SCFAs) and medium-and long-chain fatty acids (MLCFAs) in the plasma. Consequently, the levels of Isobutyric acid, Caproic acid, and Propionic acid were low both in the MDD and MDD-2w groups and negatively correlated with the scores of HAMD and HAMA. Besides, minimal changes were observed between the MDD and HC groups, whereas significant MLCFA levels were high in the MDD-2w group. Moreover, we developed combined panels that could effectively differentiate MDD from HCs (AUC=0.99), MDD-2w from HC (AUC=0.983), and MDD from MDD-2w (AUC=0.852). These findings may provide a reference for the use of B-rTMS combined with ADs against the acute phase of depressive episodes and shed light on the relationship between plasma FAs and MDD.
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Affiliation(s)
- Rui Li
- Department of Psychiatry, Chang'an Hospital, Xi'an 710000, PR China.
| | - Rui Fu
- Department of Psychiatry, Chang'an Hospital, Xi'an 710000, PR China.
| | - Wen-Mao Yang
- Department of Psychiatry, Chang'an Hospital, Xi'an 710000, PR China.
| | - Zhi-Quan Cui
- Department of Psychiatry, Chang'an Hospital, Xi'an 710000, PR China.
| | - Xue-Jun Liang
- Department of Psychiatry, Chang'an Hospital, Xi'an 710000, PR China; Mental Diseases Prevention and Treatment Institute of Chinese PLA, No. 988 Hospital of Joint Logistic Support Force, Jiaozuo, Henan Province 454003, PR China.
| | - Jia-Bin Yang
- Department of Psychiatry, Chang'an Hospital, Xi'an 710000, PR China.
| | - Ling Liu
- Military Medical Innovation Center, Air Force Medical University, Xi'an 710032, PR China.
| | - Qing-Rong Tan
- Department of Psychiatry, Chang'an Hospital, Xi'an 710000, PR China.
| | - Zheng-Wu Peng
- Department of Psychiatry, Chang'an Hospital, Xi'an 710000, PR China.
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Antidepressants and Risk of Type 2 Diabetes Mellitus: A Population-Based Nested Case-Control Study. J Clin Psychopharmacol 2021; 40:359-365. [PMID: 32639288 DOI: 10.1097/jcp.0000000000001228] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE/BACKGROUND The increased risk of type 2 diabetes mellitus (T2DM) among users of antidepressants (ADs) might be mediated by depression. We investigated whether ADs are associated with increased risk of T2DM in patients with depression. Moreover, the relationship between binding affinities of serotonin transporter (SERT) of ADs and the risk of T2DM is examined. METHODS/PROCEDURES We conducted a retrospective nested case-control study using data from Taiwan's National Health Insurance Research Database between 2000 and 2013. A total of 3038 patients with depression, 1519 cases of T2DM, and 1519 controls matched for age, sex, and index date, were included. Exposure to ADs was categorized by type and SERT. The association between AD exposure and T2DM development was assessed using conditional logistic regression analysis. FINDINGS/RESULTS No association between T2DM development and selective serotonin reuptake inhibitors (adjusted odds ratio [AOR], 1.01; 95% confidence interval [CI], 0.87-1.19; P = 0.962), serotonin-norepinephrine reuptake inhibitors (AOR, 1.13; 95% CI, 0.94-1.37; P = 1.196), tricyclic antidepressants (AOR, 1.01; 95% CI, 0.85-1.21; P = 0.906), or others (AOR, 0.88; 95% CI, 0.75-1.03; P = 0.104) was found. Alternatively, no association between individual ADs and potency of affinity to SERT and the risk of T2DM was found. IMPLICATIONS/CONCLUSIONS No association between ADs and increase risk of T2DM was found in patients with depression. However, regular metabolic evaluations are recommended for patients with depression regularly taking ADs.
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Sun JW, Hernández-Díaz S, Haneuse S, Bourgeois FT, Vine SM, Olfson M, Bateman BT, Huybrechts KF. Association of Selective Serotonin Reuptake Inhibitors With the Risk of Type 2 Diabetes in Children and Adolescents. JAMA Psychiatry 2021; 78:91-100. [PMID: 32876659 PMCID: PMC7489393 DOI: 10.1001/jamapsychiatry.2020.2762] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
IMPORTANCE Concerns exist that use of selective serotonin reuptake inhibitors (SSRIs) increases the risk of developing type 2 diabetes (T2D) in adults, but evidence in children and adolescents is limited. In the absence of a randomized clinical trial, evidence must be generated using real-world data. OBJECTIVE To evaluate the safety of SSRI use in children and adolescents with respect to the associated risk of T2D. DESIGN, SETTING, AND PARTICIPANTS This cohort study of patients aged 10 to 19 years with a diagnosis for an SSRI treatment indication was conducted within the nationwide Medicaid Analytic eXtract (MAX; January 1, 2000, to December 31, 2014) and the IBM MarketScan (January 1, 2003, to September 30, 2015) databases. Data were analyzed from November 1, 2018, to December 6, 2019. EXPOSURES New users of an SSRI medication and comparator groups with no known metabolic adverse effects (no antidepressant exposure, bupropion hydrochloride exposure, or psychotherapy exposure). Within-class individual SSRI medications were compared with fluoxetine hydrochloride. MAIN OUTCOMES AND MEASURES Incident T2D during follow-up. Intention-to-treat effects were estimated using Cox proportional hazards regression models, adjusting for confounding through propensity score stratification. As-treated effects to account for continuous treatment were estimated using inverse probability weighting and marginal structural models. RESULTS A total of 1 582 914 patients were included in the analysis (58.3% female; mean [SD] age, 15.1 [2.3] years). The SSRI-treated group included 316 178 patients in the MAX database (publicly insured; mean [SD] age, 14.7 [2.1] years; 62.2% female) and 211 460 in the MarketScan database (privately insured; mean [SD] age, 15.8 [2.3] years; 63.9% female) with at least 2 SSRI prescriptions filled, followed up for a mean (SD) of 2.3 (2.0) and 2.2 (1.9) years, respectively. In publicly insured patients, initiation of SSRI treatment was associated with a 13% increased hazard of T2DM (intention-to-treat adjusted hazard ratio [aHR], 1.13; 95% CI, 1.04-1.22) compared with untreated patients. The association strengthened for continuous SSRI treatment (as-treated aHR, 1.33; 95% CI, 1.21-1.47), corresponding to 6.6 (95% CI, 4.2-10.4) additional cases of T2D per 10 000 patients treated for at least 2 years. Adjusted HRs were lower in privately insured patients (intention-to-treat aHR, 1.01 [95% CI, 0.84-1.23]; as-treated aHR, 1.10 [95% CI, 0.88-1.36]). Findings were similar when comparing SSRI treatment with psychotherapy (publicly insured as-treated aHR, 1.44 [95% CI, 1.25-1.65]; privately insured as-treated aHR, 1.21 [95% CI, 0.93-1.57]), whereas no increased risk was observed compared with bupropion treatment publicly insured as-treated aHR, 1.01 [95% CI, 0.79-1.29]; privately insured as-treated aHR, 0.87 [95% CI, 0.44-1.70]). For the within-class analysis, no medication had an increased hazard of T2D compared with fluoxetine. CONCLUSIONS AND RELEVANCE These findings suggest that children and adolescents initiating SSRI treatment may be at a small increased risk of developing T2D, particularly publicly insured patients. The magnitude of association was more modest than previously reported, and the absolute risk was small. The potential small risk should be viewed in relation to the efficacy of SSRIs for its major indications in young patients.
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Affiliation(s)
- Jenny W. Sun
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts,Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Sonia Hernández-Díaz
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | | | - Seanna M. Vine
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Mark Olfson
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Brian T. Bateman
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts,Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Krista F. Huybrechts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts,Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
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Azevedo Da Silva M, Fournier A, Boutron-Ruault MC, Balkau B, Bonnet F, Nabi H, Fagherazzi G. Increased risk of type 2 diabetes in antidepressant users: evidence from a 6-year longitudinal study in the E3N cohort. Diabet Med 2020; 37:1866-1873. [PMID: 32542873 DOI: 10.1111/dme.14345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/09/2020] [Indexed: 12/16/2022]
Abstract
AIM To examine the association between antidepressant medication use and the risk of type 2 diabetes. METHODS Data were obtained from the E3N study (Étude Épidémiologique de Femmes de la Mutuelle Générale de l'Éducation Nationale), a French cohort study initiated in 1990, with questionnaire-based follow-up every 2 or 3 years. Exposure to antidepressants was obtained from drug reimbursement files available from 2004 onwards, and individually matched with questionnaire data. Cases of type 2 diabetes were identified from drug reimbursements. Cox proportional-hazard regression models were used, with drug exposure considered as a time-varying parameter. RESULTS Of the 63 999 women who were free of drug-treated type 2 diabetes at baseline in 2005, 1124 developed type 2 diabetes over the 6-year follow-up. Current use of antidepressants was associated with an increased risk of type 2 diabetes [hazard ratio 1.34 (95% CI 1.12, 1.61)] compared to non-users. When the different types of antidepressants were considered, women who currently used selective serotonin reuptake inhibitors, imipramine-type, 'other' or 'mixed' antidepressants had a 1.25-fold (95% CI 0.99, 1.57), 1.66-fold (95% CI 1.12, 2.46), 1.35-fold (95% CI 1.00, 1.84) and 1.82-fold (95% CI 0.85, 3.86) increase in risk of type 2 diabetes compared to non-users, respectively. CONCLUSION Our study suggests a positive association between antidepressant use and the risk of type 2 diabetes among women. If this association is confirmed, screening and surveillance of glucose levels should be considered in the context of antidepressant therapy. Further studies assessing the underlying mechanisms of this association are needed. (ClinicalTrials.gov identifier: NCT03285230).
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Affiliation(s)
- M Azevedo Da Silva
- Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada
- INSERM U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
| | - A Fournier
- INSERM U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Villejuif, France
| | - M-C Boutron-Ruault
- INSERM U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Villejuif, France
| | - B Balkau
- INSERM U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- University Versailles-St Quentin, University Paris-Sud, Paris, France
| | - F Bonnet
- INSERM U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Villejuif, France
- University Versailles-St Quentin, University Paris-Sud, Paris, France
- CHU Rennes, Rennes, France
| | - H Nabi
- INSERM U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
- Département de Médecine Sociale et Préventive, Faculté de Médecine, Québec, QC, Canada
- Axe Oncologie, Centre de Recherche du CHU de Québec, Québec, QC, Canada
- Centre de Recherche sur le Cancer, Université Laval, Québec, QC, Canada
| | - G Fagherazzi
- INSERM U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
- University Paris-Saclay, University Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Villejuif, France
- Luxembourg Institute of Health, Department of Population Health, Strassen, Luxembourg
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Misra BB, Misra A. The chemical exposome of type 2 diabetes mellitus: Opportunities and challenges in the omics era. Diabetes Metab Syndr 2020; 14:23-38. [PMID: 31838434 DOI: 10.1016/j.dsx.2019.12.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 12/02/2019] [Indexed: 02/07/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is a global silent killer, with > 450 million affected adults worldwide. A diverse array of non-modifiable risk factors such as family history, age (> 45 yrs), race/ethnicity, genetics, and history of gestational diabetes and modifiable risk factors such as physical inactivity, high body fat, body weight, high blood pressure, and high cholesterol for progression of prediabetes to T2DM. Given, that the modern world human population is constantly exposed to multiple stressors in the form of physical (i.e., sound, weather etc.) and chemical environment (i.e., diet, pollutants etc.), industrialization, and modernization has led to form a basis for exposomal correlation with T2DM incidence. Over the past decade, there have been emerging reports on association of levels of persistent organic pollutants (POPs), phthalates, antibiotics, drugs, air pollution, pesticides, and heavy metals with T2DM. In this review, we discuss the well known chemical exposome that has been associated with T2DM; the tools and approaches to capture this chemical exposome, and future opportunities and challenges in this exciting area of research. We further provide a window of thoughts, whether omics technologies can help fill in the gaps to help provide high throughput exposomics datasets in an unbiased manner to help understand T2DM pathophysiology in the context of industrialization, drastic lifestyle changes, urbanization, and pollution. We also discuss and provide guidelines/call to action for future exposomics studies investigating the association of T2DM with exposomes in the context of both epidemiological and experimental approaches.
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Affiliation(s)
- Biswapriya B Misra
- Center for Precision Medicine, Department of Internal Medicine, Section of Molecular Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, 27157, NC, USA
| | - Anoop Misra
- Diabetes Foundation (India), Safdarjung Development Area, New Delhi, India; Fortis C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chirag Enclave, Nehru Place, New Delhi, India.
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Mamakou V, Hackinger S, Zengini E, Tsompanaki E, Marouli E, Serafetinidis I, Prins B, Karabela A, Glezou E, Southam L, Rayner NW, Kuchenbaecker K, Lamnissou K, Kontaxakis V, Dedoussis G, Gonidakis F, Thanopoulou A, Tentolouris N, Zeggini E. Combination therapy as a potential risk factor for the development of type 2 diabetes in patients with schizophrenia: the GOMAP study. BMC Psychiatry 2018; 18:249. [PMID: 30071838 PMCID: PMC6090901 DOI: 10.1186/s12888-018-1826-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 07/23/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Schizophrenia (SCZ) is associated with increased risk of type 2 diabetes (T2D). The potential diabetogenic effect of concomitant application of psychotropic treatment classes in patients with SCZ has not yet been evaluated. The overarching goal of the Genetic Overlap between Metabolic and Psychiatric disease (GOMAP) study is to assess the effect of pharmacological, anthropometric, lifestyle and clinical measurements, helping elucidate the mechanisms underlying the aetiology of T2D. METHODS The GOMAP case-control study (Genetic Overlap between Metabolic and Psychiatric disease) includes hospitalized patients with SCZ, some of whom have T2D. We enrolled 1653 patients with SCZ; 611 with T2D and 1042 patients without T2D. This is the first study of SCZ and T2D comorbidity at this scale in the Greek population. We retrieved detailed information on first- and second-generation antipsychotics (FGA, SGA), antidepressants and mood stabilizers, applied as monotherapy, 2-drug combination, or as 3- or more drug combination. We assessed the effects of psychotropic medication, body mass index, duration of schizophrenia, number of hospitalizations and physical activity on risk of T2D. Using logistic regression, we calculated crude and adjusted odds ratios (OR) to identify associations between demographic factors and the psychiatric medications. RESULTS Patients with SCZ on a combination of at least three different classes of psychiatric drugs had a higher risk of T2D [OR 1.81 (95% CI 1.22-2.69); p = 0.003] compared to FGA alone therapy, after adjustment for age, BMI, sex, duration of SCZ and number of hospitalizations. We did not find evidence for an association of SGA use or the combination of drugs belonging to two different classes of psychiatric medications with increased risk of T2D [1.27 (0.84-1.93), p = 0.259 and 0.98 (0.71-1.35), p = 0.885, respectively] compared to FGA use. CONCLUSIONS We find an increased risk of T2D in patients with SCZ who take a combination of at least three different psychotropic medication classes compared to patients whose medication consists only of one or two classes of drugs.
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Affiliation(s)
- Vasiliki Mamakou
- Medical School, National and Kapodistrian University Athens, 75 M. Assias Street, 115 27, Athens, Greece. .,Dromokaiteio Psychiatric Hospital, 124 61, Athens, Greece.
| | - Sophie Hackinger
- 0000 0004 0606 5382grid.10306.34Wellcome Sanger Institute, Hinxton, Cambridge, HH CB10 1 UK
| | - Eleni Zengini
- Dromokaiteio Psychiatric Hospital, 124 61 Athens, Greece ,0000 0004 1936 9262grid.11835.3eDepartment of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Evgenia Tsompanaki
- 0000 0001 2179 8267grid.16299.35School of Information Sciences and Technology, Department of Statistics, Athens University of Economics and Business, 10434 Athens, Greece
| | - Eirini Marouli
- 0000 0001 2171 1133grid.4868.2William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, EC1M 6BQ, London, UK
| | - Ioannis Serafetinidis
- grid.414012.2Department of Gastroenterology, Gennimatas General Hospital, 11527 Athens, Greece
| | - Bram Prins
- 0000 0004 0606 5382grid.10306.34Wellcome Sanger Institute, Hinxton, Cambridge, HH CB10 1 UK
| | | | - Eirini Glezou
- Dromokaiteio Psychiatric Hospital, 124 61 Athens, Greece
| | - Lorraine Southam
- 0000 0004 0606 5382grid.10306.34Wellcome Sanger Institute, Hinxton, Cambridge, HH CB10 1 UK ,0000 0004 1936 8948grid.4991.5Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Nigel W. Rayner
- 0000 0004 0606 5382grid.10306.34Wellcome Sanger Institute, Hinxton, Cambridge, HH CB10 1 UK ,0000 0004 1936 8948grid.4991.5Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK ,0000 0004 0606 4224grid.470392.bOxford Centre for Diabetes Endocrinology and Metabolism, Oxford, UK
| | - Karoline Kuchenbaecker
- 0000 0004 0606 5382grid.10306.34Wellcome Sanger Institute, Hinxton, Cambridge, HH CB10 1 UK
| | - Klea Lamnissou
- 0000 0001 2155 0800grid.5216.0National and Kapodistrian University of Athens, Department of Biology, Athens, Panepistimioupolis, AnoIlisia, 15771 Athens, Greece
| | - Vassilis Kontaxakis
- 0000 0001 2155 0800grid.5216.0Early Psychosis Unit, 1st Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - George Dedoussis
- 0000 0004 0622 2843grid.15823.3dDepartment of Nutrition-Dietetics, Harokopio University, 17671 Athens, Greece
| | - Fragiskos Gonidakis
- 0000 0001 2155 0800grid.5216.01st Psychiatric Department, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Anastasia Thanopoulou
- 0000 0001 2155 0800grid.5216.0Diabetes Centre, 2nd Department of Internal Medicine, Hippokration General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Nikolaos Tentolouris
- First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens, Medical School, Laiko General Hospital, 11527 Athens, Greece
| | - Eleftheria Zeggini
- 0000 0004 0606 5382grid.10306.34Wellcome Sanger Institute, Hinxton, Cambridge, HH CB10 1 UK
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Effects of psychopharmacological treatment with antidepressants on the vascular system. Vascul Pharmacol 2017; 96-98:11-18. [DOI: 10.1016/j.vph.2017.07.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 07/23/2017] [Indexed: 02/08/2023]
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8
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Salvi V, Grua I, Cerveri G, Mencacci C, Barone-Adesi F. The risk of new-onset diabetes in antidepressant users - A systematic review and meta-analysis. PLoS One 2017; 12:e0182088. [PMID: 28759599 PMCID: PMC5536271 DOI: 10.1371/journal.pone.0182088] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 07/12/2017] [Indexed: 12/02/2022] Open
Abstract
Background Antidepressant Drugs (ADs) are among the most commonly prescribed medications in developed countries. The available epidemiological evidence suggests an association between AD use and higher risk of developing type 2 diabetes mellitus. However, some methodological issues make the interpretation of these results difficult. Moreover, very recent studies provided conflicting results. Given the high prevalence of both diabetes and AD use in many countries, clarifying whether this association is causal is of extreme relevance for the public health. The aim of the present study is to provide an up-to-date evaluation of the evidence in support of a causal role of ADs in inducing diabetes. Methods and findings A systematic literature search was conducted to identify relevant studies in MEDLINE (PubMed), PsycINFO, and International Pharmaceutical Abstracts (IPA) through 31st December 2016. Only studies assessing the incidence of new-onset diabetes in subjects treated with ADs were included. Results were pooled using a random-effects meta-analysis. Moreover, we extensively reviewed the role of the different sources of bias that have been proposed to explain the association between AD and diabetes. Twenty studies met the inclusion criteria. In the meta-analysis, the association between AD use and diabetes was still evident after the inclusion of the recent negative studies [pooled relative risk = 1.27, 95% confidence interval (CI), 1.19–1.35; p<0.001]. None of the biases proposed by previous authors seemed able to fully explain the observed association. Conclusions This updated meta-analysis confirms the association between AD use and incident diabetes. It still remains a matter of debate whether single ADs exert a different effect on the risk of diabetes. Given the possible heterogeneity, we suggest that a classification of ADs according to their pharmacological profiles could be useful in better elucidating the nature of this association.
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Affiliation(s)
- Virginio Salvi
- Department of Neuroscience, ASST Fatebenefratelli-Sacco, Milan, Italy
- * E-mail:
| | - Ilaria Grua
- Department of Pharmaceutical Sciences, University of Eastern Piedmont, Novara, Italy
| | - Giancarlo Cerveri
- Department of Neuroscience, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Claudio Mencacci
- Department of Neuroscience, ASST Fatebenefratelli-Sacco, Milan, Italy
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Carvalho AF, Sharma MS, Brunoni AR, Vieta E, Fava GA. The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature. PSYCHOTHERAPY AND PSYCHOSOMATICS 2017; 85:270-88. [PMID: 27508501 DOI: 10.1159/000447034] [Citation(s) in RCA: 348] [Impact Index Per Article: 49.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 05/24/2016] [Indexed: 11/19/2022]
Abstract
Newer generation antidepressant drugs (ADs) are widely used as the first line of treatment for major depressive disorders and are considered to be safer than tricyclic agents. In this critical review, we evaluated the literature on adverse events, tolerability and safety of selective serotonin reuptake inhibitors, serotonin noradrenaline reuptake inhibitors, bupropion, mirtazapine, trazodone, agomelatine, vilazodone, levomilnacipran and vortioxetine. Several side effects are transient and may disappear after a few weeks following treatment initiation, but potentially serious adverse events may persist or ensue later. They encompass gastrointestinal symptoms (nausea, diarrhea, gastric bleeding, dyspepsia), hepatotoxicity, weight gain and metabolic abnormalities, cardiovascular disturbances (heart rate, QT interval prolongation, hypertension, orthostatic hypotension), genitourinary symptoms (urinary retention, incontinence), sexual dysfunction, hyponatremia, osteoporosis and risk of fractures, bleeding, central nervous system disturbances (lowering of seizure threshold, extrapyramidal side effects, cognitive disturbances), sweating, sleep disturbances, affective disturbances (apathy, switches, paradoxical effects), ophthalmic manifestations (glaucoma, cataract) and hyperprolactinemia. At times, such adverse events may persist after drug discontinuation, yielding iatrogenic comorbidity. Other areas of concern involve suicidality, safety in overdose, discontinuation syndromes, risks during pregnancy and breast feeding, as well as risk of malignancies. Thus, the rational selection of ADs should consider the potential benefits and risks, likelihood of responsiveness to the treatment option and vulnerability to adverse events. The findings of this review should alert the physician to carefully review the appropriateness of AD prescription on an individual basis and to consider alternative treatments if available.
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Affiliation(s)
- André F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
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Azevedo Da Silva M, Balkau B, Roussel R, Tichet J, Fumeron F, Fagherazzi G, Nabi H. Longitudinal association of antidepressant medication use with metabolic syndrome: Results of a 9-year follow-up of the D.E.S.I.R. cohort study. Psychoneuroendocrinology 2016; 74:34-45. [PMID: 27567119 DOI: 10.1016/j.psyneuen.2016.08.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 08/19/2016] [Accepted: 08/19/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To examine longitudinal associations between antidepressant medication use and the metabolic syndrome (MetS). METHODS 5014 participants (49.8% were men) from the D.E.S.I.R. cohort study, aged 30-65 years at baseline in 1994-1996, were followed over 9 years at 3-yearly intervals (1997-1999, 2000-2002, and 2003-2005). Antidepressant use and MetS, defined by the National Cholesterol Education Program Adult Treatment Panel III criteria (NCEP-ATP III) and the American Heart Association and the National Heart, Lung and Blood Institute (AHA/NHLBI) criteria, were assessed concurrently at four medical examinations. RESULTS In fully-adjusted longitudinal logistic regression analyses based on generalized estimating equations, antidepressant users had a 9% (p=0.011) and a 6% (p=0.036) greater annual increase in the odds of having the MetS defined by NCEP-ATP III and AHA/NHLBI criteria respectively. Sex-specific analyses showed that this association was confined to men only. When the different types of antidepressant were considered, men who used selective serotonin reuptake inhibitors (SSRIs), imipramine type antidepressants or "other" antidepressants had a 52% (p=0.028), 31% (p=0.011), and 16% (p=0.016) greater annual increase in the odds of having the MetS over time compared to non-users, respectively. These associations depended on the definition of the MetS. CONCLUSIONS Our longitudinal data showed that antidepressant use was associated with an increased odds of having the MetS in men but not in women and this was mainly for SSRIs, imipramine type and "other" antidepressants. People on antidepressants may need to be checked regularly for the elements of the metabolic syndrome treatable by change in diet, physical activity and/or by medication therapy.
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Affiliation(s)
- Marine Azevedo Da Silva
- INSERM, Centre for Research in Epidemiology and Population Health, U1018, F-94807, Villejuif, France; University Versailles Saint-Quentin-en-Yvelines, UMRS 1018, F-78035, Versailles, France.
| | - Beverley Balkau
- INSERM, Centre for Research in Epidemiology and Population Health, U1018, F-94807, Villejuif, France; University Versailles Saint-Quentin-en-Yvelines, UMRS 1018, F-78035, Versailles, France; University Paris Sud 11, UMRS 1018, F-94807, Villejuif, France
| | - Ronan Roussel
- Service d'Endocrinologie, Diabétologie et Nutrition, DHU FIRE, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM, Centre de Recherche des Cordeliers, U1138, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Jean Tichet
- Institut inter Régional pour la Santé (IRSA), La Riche, France
| | - Frédéric Fumeron
- INSERM, Centre de Recherche des Cordeliers, U1138, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Guy Fagherazzi
- INSERM, Centre for Research in Epidemiology and Population Health, U1018, F-94807, Villejuif, France; University Paris Sud 11, UMRS 1018, F-94807, Villejuif, France
| | - Hermann Nabi
- INSERM, Centre for Research in Epidemiology and Population Health, U1018, F-94807, Villejuif, France; University Versailles Saint-Quentin-en-Yvelines, UMRS 1018, F-78035, Versailles, France
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Diabetes and brain health: implications for practice. Ir J Psychol Med 2016; 33:179-191. [PMID: 30115190 DOI: 10.1017/ipm.2015.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND It is widely accepted that people with mental illness have increased risk of cardiometabolic complications such as obesity and type 2 diabetes mellitus. What is less well known is that individuals with diabetes have an increased risk of brain health complications including depression, cognitive impairment and dementia. These conditions can adversely influence disease self-management and further increase risk of other diabetes complications. Aim The aim of this paper is to highlight the increased risk of brain health complications in populations with diabetes in order to promote awareness of such complications among healthcare professionals and encourage timely intervention. METHODS An overview of the prevalence and potential mechanisms linking depression and cognitive impairment with diabetes as well as implications for detection, management and brain health protection, based on a narrative review of the literature. CONCLUSIONS Early detection and effective management of depression and cognitive impairment among individuals with diabetes has the potential to minimise adverse health outcomes. In order to promote screening healthcare professionals caring for individuals with diabetes in all settings must be aware of the increased risk of brain health complications in this vulnerable population.
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Ferrie JE. Focus on Framingham. Int J Epidemiol 2016; 44:1755-62. [PMID: 27088149 DOI: 10.1093/ije/dyv348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kivimäki M, Batty GD. Commentary: Antidepressants and diabetes risk: why are there discrepant findings from cohort studies based on patient records and those based on serial phenotyping? Int J Epidemiol 2015; 44:1940-2. [PMID: 26371208 PMCID: PMC4690001 DOI: 10.1093/ije/dyv186] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2015] [Indexed: 11/24/2022] Open
Affiliation(s)
- Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - G David Batty
- Department of Epidemiology and Public Health, University College London, London, UK
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