Long-Term Use of Antidepressants for Depressive Disorders and the Risk of Diabetes Mellitus
Long-Term Use of Antidepressants for Depressive Disorders and the Risk of Diabetes Mellitus
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DOI：
10.1176/appi.ajp.2008.08071065
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发表时间：
2009-05-01
影响因子：
17.7
通讯作者：
Garbe, Edeltraut
中科院分区：
文献类型：
--
作者：
Andersohn, Frank;Schade, Rene;Garbe, Edeltraut
目的：据报道，使用抗抑郁药会导致体重增加。本研究的目的是评估与抗抑郁药治疗相关的糖尿病风险，并检查风险是否受到治疗时间或日剂量的影响。方法：这是一项巢式病例对照研究，纳入165,958名抑郁症患者，这些患者在1990年1月1日至2005年6月30日期间至少接受过一次新的抗抑郁药物处方。数据来自英国全科医学研究数据库。患者在入组时至少30岁且无糖尿病。结果：共发现2243例糖尿病患者和8963例匹配对照。与过去2年内未使用抗抑郁药的患者相比，近期长期使用每日中剂量至高剂量抗抑郁药（bbb24个月）与糖尿病风险增加相关（发病率比=1.84,95% CI=1.35-2.52）。长期使用中剂量至高剂量三环类抗抑郁药（发病率比=1.77,95% CI=1.21-2.59）和选择性血清素再摄取抑制剂（发病率比=2.06,95% CI=1.20-3.52）的风险程度相似。较短的治疗周期或较低的日剂量与风险增加无关。结论：长期服用每日至少中等剂量的抗抑郁药与糖尿病风险增加有关。三环类抗抑郁药和选择性血清素再摄取抑制剂均观察到这种关联。
Objective: Use of antidepressants has been reported to cause considerable weight gain. The aim of this study was to assess the risk of diabetes mellitus associated with antidepressant treatment and to examine whether the risk is influenced by treatment duration or daily dose.Method: This was a nested case-control study in a cohort of 165,958 patients with depression who received at least one new prescription for an antidepressant between January 1, 1990, and June 30, 2005. Data were from from the U. K. General Practice Research Database. Patients were at least 30 years of age and without diabetes at cohort entry.Results: A total of 2,243 cases of incident diabetes mellitus and 8,963 matched comparison subjects were identified. Compared with no use of antidepressants during the past 2 years, recent long-term use (>24 months) of antidepressants in moderate to high daily doses was associated with an increased risk of diabetes (incidence rate ratio=1.84, 95% CI=1.35-2.52). The magnitude of the risk was similar for long-term use of moderate to high daily doses of tricyclic antidepressants (incidence rate ratio=1.77, 95% CI=1.21-2.59) and selective serotonin reuptake inhibitors (incidence rate ratio=2.06, 95% CI=1.20-3.52). Treatment for shorter periods or with lower daily doses was not associated with an increased risk.Conclusions: Long-term use of antidepressants in at least moderate daily doses was associated with an increased risk of diabetes. This association was observed for both tricyclic antidepressants and selective serotonin reuptake inhibitors.