Contact: Calum Moulton, MRCPsych
For Release: Immediately
Antidepressants are the most frequently prescribed psychiatric drugs in the U.S. A startling one out of eight Americans 12 and older take them, as do nearly one out of five over age 60. Among many other nations, usage also is soaring.
By far the most prescribed type of antidepressant is a Selective Serotonin Reuptake Inhibitor (SSRI) such as fluoxetine (often known as Prozac or Sarafem), escitalopram (Lexapro) or sertraline (Zoloft). But despite their popularity, concern has surfaced that SSRIs may raise blood sugar. Since people with diabetes are twice as likely to be depressed as those who don’t have it and the number of patients with diabetes is steadily growing, if antidepressants raise blood sugar that could hinder the health of many of us.
Now there’s new cause for optimism on this issue. The first review of research comparing people randomly assigned to varied brands of SSRI pills or placebo finds that a couple of these antidepressants significantly lower blood sugar for people with Type 2 diabetes and none of them raise sugar for any patients.
“We can say that based on our findings people taking SSRIs can be a lot more reassured that the medications are likely to be safe when it comes to blood sugars and may even improve blood sugars,” notes study senior author Calum Moulton, MRCPsych, Clinical Research Fellow in the Department of Psychological Medicine at King’s College London, UK. His coauthor is colleague Khalida Ismail, Ph.D. Their study, published online ahead of print, will appear in a forthcoming issue of Psychosomatic Medicine, journal of the American Psychosomatic Society.
Moulton surveyed 16 randomized controlled studies of medications such as fluoxetine, sertraline, citalopram, escitalopram and paroxetine. There were 835 participants in these studies, followed from between four weeks to one year. Fluoxetine, citalopram and escitalopram all significantly lowered blood sugar more than a placebo for people with Type 2 diabetes. Paroxetine didn’t raise sugar, but there wasn’t a significant improvement either. And only one study considered sertraline, yielding too little data for firm conclusions. Overall, for non-diabetics the SSRIs “came very close to lowering blood sugar,” says Moulton. “There may well be a positive effect that would show up if we had larger or more studies.” Their blood sugar levels already were lower than those of diabetics.
Weight loss, which can improve blood sugar for patients with Type 2 diabetes, didn’t account for the glycemia changes in patients taking SSRIs, says Moulton. But SSRIs have been shown to increase secretion of insulin, and that’s one likely explanation for the improvement, he adds. Also, when depressed people improve they may take better care of themselves. “They may be more likely to take their medication, to do more exercise because they’re not depressed, to eat better diets,” says Moulton, and all of these effects could improve blood sugar levels. “It’s probably a combination of things—and other things we don’t know about yet.”
“It’s important that our promising findings are now confirmed in larger and longer clinical trials,” adds Moulton. “If we are right, we could even see antidepressants used in the treatment and prevention of diabetes in the future.”
The American Psychosomatic Society (APS) (www.psychosomatic.org), founded in 1943, is an international multidisciplinary academic society that organizes an annual scientific meeting and educational programs. Psychosomatic Medicine is its scientific journal. The membership of over 700 is composed of academic scientists and clinicians in medicine, psychiatry, epidemiology, health psychology and allied health services. The mission of the APS is “to advance and integrate the scientific study of biological, psychological, behavioral and social factors in health and disease.”