- Most antidepressants except reversible inhibitors of monoamine oxidase A (RIMAs) are associated with significantly reduced mortality among patients with comorbid diabetes mellitus (DM) and depression.
Why this matters
- Effect of antidepressants on mortality in patients with diabetes is not well-studied.
- Retrospective 2000-2013 cohort study in national Taiwanese database of 53,412 individuals with both diabetes and depression, of whom 50,532 used antidepressants.
- Funding: Ministry of Health and Welfare, Taiwan.
- After adjustment for factors including sex, age, income, and comorbidities, total mortality decreased with increasing antidepressants cumulative defined daily dose (cDDD):
- At >28 vs
- At cDDD ≥84, HR was 0.65 (P<.0001>
- Males were at greater mortality risk than females: HR, 1.71 (P<.0001>
- No significant effect on overall mortality for cDDD
- Selective serotonin reuptake inhibitors: 0.64 (P<.0001>
- Serotonin-norepinephrine reuptake inhibitors: 0.59 (P=.0005);
- Norepinephrine-dopamine reuptake inhibitors: 0.20 (P=.0056);
- Mirtazapine: 0.60 (P=.0011);
- Tricyclic/tetracyclic antidepressants: 0.73 (P=.0311); and
- Trazodone: 0.52 (P=.0230).
- Specific death causes unknown.
- Validity of depression diagnosis uncertain.
- Potential residual confounders.
- All-Taiwanese population.