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Antidepressants Reduced Risk of Mortality in Patients With Diabetes Mellitus: A Population-Based Cohort Study in Taiwan.
- Source :
-
The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2019 Oct 01; Vol. 104 (10), pp. 4619-4625. - Publication Year :
- 2019
-
Abstract
- Context: The effect of antidepressant (ATD) use on mortality in patients with diabetes mellitus (DM) has not yet been sufficiently studied, although comorbid depression is common in this population.<br />Objective: To explore the impact of ATDs on mortality among DM patients.<br />Design: A retrospective cohort study in a national database.<br />Setting: This population-based study used the National Health Insurance Research Database in Taiwan. Since 2000, we identified 53,412 cases of newly diagnosed patients with DM and depression. Patient cases were followed for assessing mortality until 2013.<br />Main Outcome Measure: The association between mortality and ATD use was explored adjusting for cumulative dosing.<br />Results: Using the time-dependent Cox regression model, ATD use was associated with significantly reduced mortality among patients with DM [in the highest dose group: hazard ratio (HR), 0.65; 95% CI, 0.59 to 0.71]. Further analysis showed that differences in mortality existed across ATD categories: selective serotonin reuptake inhibitors (HR, 0.63; 95% CI, 0.56 to 0.71), serotonin-norepinephrine reuptake inhibitors (HR, 0.58; 95% CI, 0.44 to 0.78), norepinephrine-dopamine reuptake inhibitors (HR, 0.20; 95% CI, 0.07 to 0.63), mirtazapine (HR, 0.60; 95% CI, 0.45 to 0.82), tricyclic/tetracyclic antidepressants (HR, 0.73; 95% CI, 0.54 to 0.97), and trazodone (HR, 0.52; 95% CI, 0.29 to 0.91). However, reversible inhibitor of monoamine oxidase A (RIMA) was found to be associated with an increase, rather than a decrease, in total mortality (HR, 1.48; 95% CI, 1.09 to 1.99).<br />Conclusion: Most ATDs, but not RIMA, were associated with significantly reduced mortality among a population with comorbid DM and depression.<br /> (Copyright © 2019 Endocrine Society.)
- Subjects :
- Adolescent
Adult
Aged
Antidepressive Agents, Tricyclic therapeutic use
Cohort Studies
Comorbidity
Depressive Disorder epidemiology
Depressive Disorder, Major drug therapy
Depressive Disorder, Major epidemiology
Dopamine Uptake Inhibitors therapeutic use
Dysthymic Disorder drug therapy
Dysthymic Disorder epidemiology
Female
Humans
Male
Middle Aged
Mirtazapine therapeutic use
Monoamine Oxidase Inhibitors therapeutic use
Proportional Hazards Models
Selective Serotonin Reuptake Inhibitors therapeutic use
Serotonin and Noradrenaline Reuptake Inhibitors therapeutic use
Taiwan epidemiology
Trazodone therapeutic use
Young Adult
Antidepressive Agents therapeutic use
Depressive Disorder drug therapy
Diabetes Mellitus epidemiology
Mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1945-7197
- Volume :
- 104
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- The Journal of clinical endocrinology and metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 31265070
- Full Text :
- https://doi.org/10.1210/jc.2018-02362