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Diabetes is the seventh leading cause of death worldwide. According to the American Diabetes Association, 30.3 million people in the United States (9.4% of the population) had diabetes in 2015.
Antidepressants associated with decreased mortality rates in patients with diabetes and depression https://t.co/3vi1k0Krh5
— I.M. Matters from ACP (@IMMattersACP) July 9, 2019
The World Health Organization (WHO) class depression as the leading cause of disability worldwide. In the United States, around 17.3 million adults (7.1% of the population) experienced “at least one major depressive episode” in 2017. Having diabetes increases a person’s chance of developing depression by two to three times, but only 25–50% of those with both conditions receive treatment.
“The reduction of mortality in individuals with [diabetes] remains a critically important and unmet need,” explain Dr. Vincent Chin-Hung Chen — of Chiayi Chang Gung Memorial Hospital and Chang Gung University in Puzi, Taiwan — and colleagues in a recent paper in The Journal of Clinical Endocrinology & Metabolism.
The team set out to investigate whether taking antidepressants affects mortality rates in people who have both diabetes and depression.
Read more: Have scientists found a way to reverse diabetes?
Higher doses linked to fewer deaths
“The incidence of major depressive disorder [among] individuals with diabetes is significantly greater than the general population,” says Dr. Chen. “Diabetes and depression each independently contribute to increasing total mortality.”
Dr. Chen and colleagues used data from the Taiwan National Health Insurance Research Database and identified 53,412 people who had first received a diagnosis of diabetes and then an additional diagnosis of depression.
For the purpose of their study, the team defined “depression” as having had at least one psychiatric admission or three psychiatric outpatient visits and having received a diagnosis from a psychiatrist.
In patients with #diabetes and #depression, use of high-dose antidepressants is associated with a 35% lower mortality risk, compared with use of low-dose antidepressants. https://t.co/BCSRATFHdI pic.twitter.com/OeYkVxdh1g
— NEJM Journal Watch (@JWatch) July 6, 2019
Of all the people in the study, 50,532 used antidepressants. The scientists divided the people who took antidepressants into three groups based on how much of a particular drug they took each day. The groups were low, medium, and high cumulative daily dose groups.
Read more: Can chocolate prevent type-2 diabetes?
When the researchers analyzed the data, they found that as the daily dose increased, death rates decreased. Specifically, the data showed an incident rate of death of 1,963.7 per 100,000 person-years in the low dose group and 1113.7 per 100,000 person-years in the high dose group.
In other words, taking high daily doses of antidepressants was linked to a 35% reduction in mortality when compared with taking low daily doses. Other factors that increased a person’s risk of death in the study cohort were being male, living in a rural area, having a lower socioeconomic status, and having more severe depression.