Psychiatrists and other doctors treating depression are being advised to be judicious about prescribing antidepressants to patients at risk for type 2 diabetes, in the wake of new findings suggesting a link between the medications and likelihood of developing diabetes. The mechanism is unclear; while some antidepressants are known to cause weight gain, which is a diabetes risk factor, some of the studies researchers looked at showed a connection even when accounting for weight and other risk factors. The results even held when accounting for the diabetes risk factors, such as inactivity, poor diet, and smoking.
"While depression is an important clinical problem and antidepressants are effective treatments for this debilitating condition, clinicians need to be aware of the potential risk of diabetes, particularly when using antidepressants in higher doses or for longer duration," said Richard Holt, one of the researchers involved in the latest study, in a statement. "When prescribing antidepressants, doctors should be aware of this risk and take steps to monitor for diabetes and reduce that risk of diabetes through lifestyle modification."
Other risk factors include a family history of diabetes, being over 45, having developed gestational diabetes during pregnancy, or having given birth to a baby over nine pounds. People who are black, Hispanic, or of Asian or Pacific Island decent are also more prone to type 2 diabetes. Some health conditions tend to lead to diabetes also. People with high blood pressure, low levels of HDL cholesterol, or high triglyceride levels are likely to develop the conditions. People with these conditions should be cautious about taking antidepressants for a long time or at high doses.
In contract, the hormone melatonin, often taken in supplement form as a sleep aid, might help prevent diabetes. A study in Boston found that people with lower levels of melatonin in their blood are more than twice as likely to develop diabetes. This only raises the possibility that raising a person;s level of the hormone will prevent diabetes, but it is known that melatonin can prevent or reduce weight gain, lowering diabetes risk that way.