title: Use of antidepressant medication and risk of type 2 diabetes: results from three cohorts of US adults.
abstract: OBJECTIVE
  The results of several studies have suggested a potential positive association between use of antidepressant medication (ADM) and incident type 2 diabetes mellitus. We examined this association in three cohorts of US adults.
  
  
  METHODS
  We followed 29,776 men in the Health Professionals Follow-up Study (HPFS, 1990-2006), 61,791 women in the Nurses' Health Study I (NHS I, 1996-2008) and 76,868 women in NHS II (1993-2005), who were free of diabetes mellitus, cardiovascular disease or cancer at baseline. The mean baseline ages for participants from the HPFS and NHS I and II were 56.4, 61.3 and 38.1 years, respectively. ADM use and other covariates were assessed at baseline and updated every 2 years. A time-dependent Cox proportional hazards model was used, and HRs were pooled together across the three cohorts.
  
  
  RESULTS
  During 1,644,679 person-years of follow-up, we documented 6,641 new cases of type 2 diabetes. ADM use was associated with an increased risk of diabetes in all three cohorts in age-adjusted models (pooled HR 1.68 [95% CI 1.27, 2.23]). The association was attenuated after adjustment for diabetes risk factors and histories of high cholesterol and hypertension (1.30 [1.14, 1.49]), and further attenuated by controlling for updated BMI (1.17 [1.09, 1.25]). Use of selective serotonin reuptake inhibitors and other antidepressants (mainly tricyclic antidepressants) were both associated with an elevated risk of diabetes, with pooled multivariate-adjusted HRs of 1.10 (1.00, 1.22) and 1.26 (1.11, 1.42), respectively.
  
  
  CONCLUSIONS
  The results suggest that ADM users had a moderately elevated risk of type 2 diabetes mellitus compared with non-users, even after adjustment for BMI.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA.
authors.forename: A
authors.initials: A
authors.lastname: Pan
authors.forename: Q
authors.initials: Q
authors.lastname: Sun
authors.forename: O I
authors.initials: OI
authors.lastname: Okereke
authors.forename: K M
authors.initials: KM
authors.lastname: Rexrode
authors.forename: R R
authors.initials: RR
authors.lastname: Rubin
authors.forename: M
authors.initials: M
authors.lastname: Lucas
authors.forename: W C
authors.initials: WC
authors.lastname: Willett
authors.forename: J E
authors.initials: JE
authors.lastname: Manson
authors.forename: F B
authors.initials: FB
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015992:Body Mass Index; D015331:Cohort Studies; D003863:Depression / Q000150:complications / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced* / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006281:Health Occupations; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000150:complications; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D000928:Antidepressive Agents