Short-Term Risk of Type 2 Diabetes in Patients Using Various Antidepressants Compared with Patients Using Fluoxetine.

IF 0.5 4区 医学 Q4 PHARMACOLOGY & PHARMACY Psychiatry and Clinical Psychopharmacology Pub Date : 2024-11-28 DOI:10.5152/pcp.2024.24917
Hee-Cheol Kim
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Abstract

Background: The objective is to compare the risk of developing type 2 diabetes (T2D) within a year in patients prescribed various antidepressants (ADs) and those prescribed fluoxetine as a control group.

Methods: This study used standardized data from the Health Insurance Review and Assessment Service claims database (n=1,456,489). Patients aged ≥10 years with no previous use of ADs and no history of diabetes mellitus, regardless of whether they were diagnosed with any depressive disorder, were eligible for this study. Among these eligible patients, those who had used ADs for the first time or had never used them between January 2017 and December 2017 were selected for this study. I compared the short-term (<12 months) risk of T2D in patients using various ADs, excluding tricyclic ADs, with those using fluoxetine as a control. The Cox proportional hazards model was used to calculate hazard ratios (HRs).

Results: The HRs (95% confidence intervals) for T2D incidence in the various AD groups compared with that in the fluoxetine group are as follows: 0.84 (0.67-1.06, P = .15), bupropion; 0.91 (0.77- 1.07, P=.25), tianeptine; 0.91 (0.77-1.07, P=.25), escitalopram; 0.96 (0.82-1.13, P = .63), paroxetine; 0.97 (0.70-1.35, P=.87), fluvoxamine; 1.07 (0.85-1.36, P=.55), vortioxetine; 1.07 (0.91-1.25, P=.42), sertraline; 1.14 (0.99-1.31, P = .07), duloxetine; 1.17 (0.97-1.41, P = .09), mirtazapine; 1.17 (1.00-1.38, P=.05), trazodone; 1.22 (1.04-1.45, P=.02), venlafaxine; and 1.29 (1.03-1.61, P = .03), milnacipran.

Conclusion: The short-term risk of T2D was significantly higher in the milnacipran and venlafaxine groups than in the fluoxetine group. All other ADs except milnacipran and venlafaxine showed no difference in the risk of developing T2D compared to fluoxetine. These results suggest that clinicians should be mindful of the risk of developing T2D when administering milnacipran and venlafaxine to patients.

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不同抗抑郁药物与氟西汀治疗2型糖尿病的短期风险比较
背景:目的是比较服用各种抗抑郁药(ADs)的患者和服用氟西汀作为对照组的患者在一年内发生2型糖尿病(T2D)的风险。方法:本研究使用来自健康保险审查和评估服务索赔数据库的标准化数据(n=1,456,489)。年龄≥10岁,既往无ad使用史,无糖尿病史的患者,无论是否诊断为抑郁症,均符合本研究的条件。在这些符合条件的患者中,选择2017年1月至2017年12月期间首次使用或从未使用过ADs的患者参加本研究。结果:与氟西汀组相比,各AD组T2D发生率的HRs(95%可信区间)分别为:0.84 (0.67-1.06,P = 0.15),安非他酮;0.91 (0.77 ~ 1.07, P= 0.25),天奈肽;0.91 (0.77 ~ 1.07, P= 0.25),艾司西酞普兰;0.96 (0.82-1.13, P = 0.63),帕罗西汀;0.97 (0.70 ~ 1.35, P= 0.87),氟伏沙明;1.07 (0.85 ~ 1.36, P= 0.55),沃替西汀;1.07 (0.91-1.25, P= 0.42),舍曲林;1.14 (0.99 ~ 1.31, P = 0.07),度洛西汀;1.17 (0.97-1.41, P = 0.09),米氮平;1.17 (1.00-1.38, P= 0.05),曲唑酮;1.22 (1.04 ~ 1.45, P= 0.02),文拉法辛;milnacipran为1.29 (1.03 ~ 1.61,P = .03)。结论:米那西普兰和文拉法辛组T2D短期风险明显高于氟西汀组。与氟西汀相比,除米那西普兰和文拉法辛外,所有其他ad在发生T2D的风险方面没有差异。这些结果表明,临床医生在给患者使用米那西普兰和文拉法辛时应注意发生T2D的风险。
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来源期刊
Psychiatry and Clinical Psychopharmacology
Psychiatry and Clinical Psychopharmacology Medicine-Psychiatry and Mental Health
CiteScore
1.00
自引率
14.30%
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0
期刊介绍: Psychiatry and Clinical Psychopharmacology aims to reach a national and international audience and will accept submissions from authors worldwide. It gives high priority to original studies of interest to clinicians and scientists in applied and basic neurosciences and related disciplines. Psychiatry and Clinical Psychopharmacology publishes high quality research targeted to specialists, residents and scientists in psychiatry, psychology, neurology, pharmacology, molecular biology, genetics, physiology, neurochemistry, and related sciences.
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