Burcu M, et al. - An exploratory analysis was pursued of the tie-up between antidepressant use and the risk of incident type 2 diabetes in youths by antidepressant subclass and according to the duration of use, cumulative dose, and average daily dose. Herein, the use of selective serotonin reuptake inhibitors [SSRIs] or serotonin-norepinephrine reuptake inhibitors [SNRIs]-the most commonly used antidepressant subclass-exhibited a correlation with an increased risk of type 2 diabetes. This, in turn, intensified with increasing duration of use, cumulative dose, and average daily dose.

Methods

• The plot of this research was a retrospective cohort study.
• It utilized the Medicaid claims data from 4 geographically diverse, large states of youths 5 to 20 years of age, who initiated antidepressant treatment from January 1, 2005, to December 31, 2009.
• An analysis was pursued of the antidepressant use (selective serotonin reuptake inhibitors [SSRIs] or serotonin-norepinephrine reuptake inhibitors [SNRIs], tricyclic or other cyclic antidepressants, and other antidepressants) using the following 4 time-varying measures: Current or former use, duration of use, cumulative dose, and average daily dose.
• The primary measure comprised of an examination of the incident type 2 diabetes via discrete-time failure models, adjusting for disease risk score estimated with the aid of more than 125 baseline and time-dependent covariates.

Results

• Among 119608 youths aged 5 to 20 years who initiated antidepressant treatment (59087 female youths and 60521 male youths; 54.7% between 5 and 14 years of age) with a mean follow-up of 22.8 months, 79285 [66.3%] had SSRI or SNRI exposure.
• A substantially greater risk of type 2 diabetes was reported during current use than former use of SSRIs or SNRIs (absolute risk, 1.29 per 10000 person-months vs 0.64 per 10000 person-months; adjusted relative risk [RR], 1.88; 95% CI, 1.34-2.64) and tricyclic or other cyclic antidepressants (absolute risk, 0.89 per 10000 person-months vs 0.48 per 10000 person-months; RR, 2.15; 95% CI, 1.06-4.36), but not of other antidepressants (absolute risk, 1.15 per 10000 person-months vs 1.12 per 10000 person-months; RR, 0.99; 95% CI, 0.66-1.50).
• In the case of youths currently using SSRIs or SNRIs, raised risk of type 2 diabetes was noted with the duration of use (RR, 2.66; 95% CI, 1.45-4.88 for >210 days and RR, 2.56; 95% CI, 1.29-5.08 for 151-210 days compared with 1-90 days) and with the cumulative dose (RR, 2.44; 95% CI, 1.35-4.43 for >4500 mg and RR, 2.17; 95% CI, 1.07-4.40 for 3001-4500 mg compared with 1-1500 mg in fluoxetine hydrochloride dose equivalents).
• On the other hand, there was no correlation between the duration and the cumulative dose of other antidepressants with an increased risk of type 2 diabetes.
• The risk of type 2 diabetes demonstrated a prominent rise with the average daily dose among youths with more than 150 days of SSRI or SNRI use (RR, 2.39; 95% CI, 1.04-5.52 for >15.0 vs ≤15.0 mg/d) but not among youths with 1 to 150 days of SSRI or SNRI use.