Treating Depression May Reduce Mortality in Diabetes Patients

The use of most types of antidepressants (ATDs) is associated with significantly reduced mortality among patients with diabetes mellitus (DM) and comorbid depression, according to a study published online in the Journal of Clinical Endocrinology & Metabolism.

Hong-Ming Chen, M.D., from the Chiayi Chang Gung Memorial Hospital in Chiayi, Taiwan, China, and colleagues conducted a retrospective cohort study using the National Health Insurance Research Database in Taiwan, China. Since 2000, the authors identified 53,412 patients with newly diagnosed DM and depression, who were followed until 2013 to assess mortality.

Using a time-dependent Cox regression model, the researchers found that use of ATDs was associated with significantly reduced mortality (hazard ratio [HR], 0.65; 95 percent confidence interval [CI], 0.59 to 0.71). The reductions in mortality risk differed across categories of ATDs: selective serotonin reuptake inhibitors (HR, 0.63; 95 percent CI, 0.56 to 0.71), serotonin-norepinephrine reuptake inhibitors (HR, 0.58; 95 percent CI, 0.44 to 0.78), norepinephrine-dopamine reuptake inhibitors (HR, 0.20; 95 percent CI, 0.07 to 0.63), mirtazapine (HR, 0.60; 95 percent CI, 0.45 to 0.82), tricyclic/tetracyclic antidepressants (HR, 0.73; 95 percent CI, 0.54 to 0.97), and trazodone (HR, 0.52; 95 percent CI, 0.29 to 0.91). In contrast to other ATDs, reversible inhibitors of monoamine oxidase A (RIMA) were associated with an increase in total mortality risk (HR, 1.48; 95 percent CI, 1.09 to 1.99).

"To our knowledge, this is the first large population-based cohort study to identify an inverse association between ATD use and mortality among individuals diagnosed with DM and comorbid depression," write the authors.

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