Comparisons of glucose-insulin homeostasis following maprotiline and fluoxetine treatment in depressed males.
BACKGROUND
To investigate the effects of antidepressants on glucose-insulin homeostasis, we provided homogenous situation and performed standard procedures to assess the interactions of antidepressants and glucose regulation during hospitalization.


METHODS
Twenty-three non-diabetic depressed males were recruited and assigned to two groups based on the antidepressants received (maprotiline n=11, fluoxetine n=12). The severity of depression was evaluated using a 21-item Hamilton depression rating scale (HAM-D). Before and after the 4-week treatment, participants underwent 75-g oral glucose tolerance test (OGTT) and frequently sampled intravenous glucose tolerance test (FSIGT). Insulin sensitivity (SI), glucose effectiveness (SG), acute insulin response (AIR), and disposition index (DI) were estimated using minimal model method.


RESULTS
The HAM-D scores were reduced significantly (P<0.005) after antidepressant treatment. Following maprotiline treatment, the body weight and BMI were significantly increased (P=0.02). Individuals treated with maprotiline displayed a significantly increased AIR (3239+/-682 vs. 4698+/-597 pmol; P=0.04) during the FSIGT.


CONCLUSIONS
The sample size was limited. Furthermore, the study was conducted in the early phase of depression-treated course.


CONCLUSIONS
The results suggest that the beta-cell function is hyperbolic in order to offset the insulin resistance following maprotiline treatment. Our findings imply that norepinephrine reuptake inhibitor (NRI) antidepressants might attenuate insulin sensitivity.
Chen
Yi-Chyan
YC
Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. yichanc@ndmctsgh.edu.tw
Shen
Yu-Chih
YC
Hung
Yi-Jen
YJ
Chou
Chao-Ha
CH
Yeh
Chin-Bin
CB
Perng
Cheng-Hwang
CH
D018759:Adrenergic Uptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000627:therapeutic use*; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects; D003865:Major Depressive Disorder / Q000097:blood / Q000188:drug therapy*; D005473:Fluoxetine / Q000009:adverse effects / Q000627:therapeutic use*; D005951:Glucose Tolerance Test; D006706:Homeostasis / Q000187:drug effects*; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000187:drug effects; D008297:Male; D008376:Maprotiline / Q000009:adverse effects / Q000627:therapeutic use*; D010555:Personality Inventory; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*
D018759:Adrenergic Uptake Inhibitors; D018687:Antidepressive Agents, Second-Generation; D001786:Blood Glucose; D005473:Fluoxetine; D007328:Insulin; D008376:Maprotiline; D017367:Selective Serotonin Reuptake Inhibitors