Antidepressant Use Reduces Mortality 35 Percent Among Diabetics

A recent study has found that antidepressant use could reduce more than a third of deaths in patients with diabetes and depression.

After examining a cohort of more than 50,000 patients, investigators found that most antidepressants, but not reversible inhibitor of monoamine oxidase, were associated with significantly reduced mortality among the study population.

With the prevalence of depression among diabetics 2 to 3 times greater than non-diabetic patients, investigators sought to determine the effect of antidepressants on mortality in these patients. Using the Taiwan National Health Insurance Research Database, investigators identified 53,412 individuals, of which 50,532 were using antidepressants and 2880 people were not.

Investigators used 4 comorbid chronic diseases as confounding variables. Urbanization and financial status were divided into 4 levels and risk of mortality was evaluated but comparing the highest dose group to the lowest dose group.

When comparing the group using antidepressants compared to the non-antidepressant use group, investigators noted more male and elderly individuals were in the non-antidepressant use group. The antidepressant use group had a younger age distribution, higher degree of urbanization, better socioeconomic state — this may be due to their greater accessibility to psychotropic medication.

Investigators noted that the rate of heart failure among the non-antidepressant group, the rate of heart failure was higher but no significant differences were detected between groups in regard to the other 3 comorbid chronic diseases. Additionally, the non-antidepressant use group also had higher severity of diabetes mellitus complications.

The incidence rate of deaths events ranged from 1113.7 (95 %CI: 1078.4-1150.3) per 100,000 person-years in the highest group to 1963.7 (95%CI: 1876.8-2054.7) per 100,000 person-years in the lowest group. Investigators found that, after adjustment, the rates of mortality decreased as total cumulative dose increased.

Males were at a greater risk for mortality compared to females (HR=1.71, CI=1.63-1.80). Those living in urban areas had a lower risk of mortality compared to those in rural areas (in highest urbanization group, HR=0.75, CI=0.69-0.83). Additionally, higher financial (in best economic group, HR= 0.67, CI=0.61-0.73) status was associated with reduced mortality.

Based upon the findings of their analyses, investigators wrote the results justify further rationale for the treatment and screening of depression in patients with adults.

“This data provides further rationale for the screening and treating of depression in persons who have diabetes,” said study author Vincent Chin-Hung Chen, Professor, of Chiayi Chang Gung Memorial Hospital and Chang Gung University in Puzi, Taiwan.

This study, titled “Antidepressants Reduced Risk of Mortality in Patients with Diabetes Mellitus: A Population-Based Cohort Study in Taiwan,” is published in the Journal of Clinical Endocrinology and Metabolism.