title: Antidepressant use and diabetes mellitus risk: a meta-analysis.
abstract: BACKGROUND
  Epidemiologic studies have reported inconsistent findings regarding the association between the use of antidepressants and type 2 diabetes mellitus (DM) risk. We performed a meta-analysis to systematically assess the association between antidepressants and type 2 DM risk.
  
  
  METHODS
  We searched MEDLINE (PubMed), EMBASE, and the Cochrane Library (through Dec 31, 2011), including references of qualifying articles. Studies concerning the use of tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), or other antidepressants and the associated risk of diabetes mellitus were included.
  
  
  RESULTS
  Out of 2,934 screened articles, 3 case-control studies, 9 cohort studies, and no clinical trials were included in the final analyses. When all studies were pooled, use of antidepressants was significantly associated with an increased risk of DM in a random effect model (relative risk [RR], 1.49; 95% confidence interval [CI], 1.29 to 1.71). In subgroup analyses, the risk of DM increased among both SSRI users (RR, 1.35; 95% CI, 1.15 to 1.58) and TCA users (RR, 1.57; 95% CI, 1.26 to 1.96). The subgroup analyses were consistent with overall results regardless of study type, information source, country, duration of medication, or study quality. The subgroup results considering body weight, depression severity, and physical activity also showed a positive association (RR, 1.14; 95% CI, 1.01 to 1.28). A publication bias was observed in the selected studies (Egger's test, P for bias = 0.09).
  
  
  CONCLUSIONS
  Our results suggest that the use of antidepressants is associated with an increased risk of DM.
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jae Moon
authors.initials: JM
authors.lastname: Yoon
authors.forename: Eun-Geol
authors.initials: EG
authors.lastname: Cho
authors.forename: Hyun-Ki
authors.initials: HK
authors.lastname: Lee
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Park
keywords: Antidepressive Agents; Diabetes Mellitus; Meta-Analysis; Serotonin Uptake Inhibitors; Tricyclic Antidepressive Agents
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