title: Long-term antidepressant use and the risk of type 2 diabetes mellitus: a population-based, nested case-control study in Taiwan.
abstract: OBJECTIVE
  Antidepressant drugs might induce weight gain and increase diabetes risk. We examined the diabetes risk with long-term antidepressant use in a general population.
  
  
  METHODS
  This study was a population-based, nested case-control study using Taiwan's National Health Insurance Research Database between 1998 and 2009. A total of 47,885 patients with type 2 diabetes mellitus (ICD-9 codes: 250.x; excluding 250.x 1 and 250.x 3) and 95,770 controls were identified. We used a conditional logistic regression model for data analysis and 1-year latent period before the diabetes diagnosis to account for the quantification of treatment duration of antidepressant (defined by Anatomic Therapeutic Chemical classification code N06A). Sensitivity analyses were performed using a propensity score matching method, as well as different lengths of latent periods.
  
  
  RESULTS
  Compared with nonusers, patients with cumulative antidepressant use (> 2 years) had an increased risk of diabetes (adjusted OR = 1.20; 95% CI, 1.05-1.37). Moreover, increasing mean daily dose or use of selective serotonin reuptake inhibitors or serotonin antagonist and reuptake inhibitors was associated with increased diabetes risk. The increased diabetes risk with long-term antidepressant therapy in patients aged 44 years or less (adjusted OR = 2.39; 95% CI, 1.46-3.90) was higher than that in older adults (adjusted OR = 1.15; 95% CI, 1.00-1.32).
  
  
  CONCLUSIONS
  The findings suggest that long-term antidepressant use may be associated with an increased risk of type 2 diabetes mellitus, especially for young adults. Therefore, long-term antidepressant use should be evaluated more cautiously for its benefits and the potential risk of diabetes.
authors: Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health; and Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
authors: Chi-Shin
authors: CS
authors: Wu
authors: Susan Shur-Fen
authors: SS
authors: Gau
authors: Mei-Shu
authors: MS
authors: Lai
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects*; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D012042:Registries; D012306:Risk; D012702:Serotonin Antagonists / Q000009:adverse effects*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D012702:Serotonin Antagonists; D017367:Selective Serotonin Reuptake Inhibitors