The risk of new-onset diabetes in antidepressant users - A systematic review and meta-analysis.

<h4>Background</h4>Antidepressant Drugs (ADs) are among the most commonly prescribed medications in developed countries. The available epidemiological evidence suggests an association between AD use and higher risk of developing type 2 diabetes mellitus. However, some methodological issu...

Full description

Saved in:
Bibliographic Details
Main Authors: Virginio Salvi, Ilaria Grua, Giancarlo Cerveri, Claudio Mencacci, Francesco Barone-Adesi
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0182088
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849682960978018304
author Virginio Salvi
Ilaria Grua
Giancarlo Cerveri
Claudio Mencacci
Francesco Barone-Adesi
author_facet Virginio Salvi
Ilaria Grua
Giancarlo Cerveri
Claudio Mencacci
Francesco Barone-Adesi
author_sort Virginio Salvi
collection DOAJ
description <h4>Background</h4>Antidepressant Drugs (ADs) are among the most commonly prescribed medications in developed countries. The available epidemiological evidence suggests an association between AD use and higher risk of developing type 2 diabetes mellitus. However, some methodological issues make the interpretation of these results difficult. Moreover, very recent studies provided conflicting results. Given the high prevalence of both diabetes and AD use in many countries, clarifying whether this association is causal is of extreme relevance for the public health. The aim of the present study is to provide an up-to-date evaluation of the evidence in support of a causal role of ADs in inducing diabetes.<h4>Methods and findings</h4>A systematic literature search was conducted to identify relevant studies in MEDLINE (PubMed), PsycINFO, and International Pharmaceutical Abstracts (IPA) through 31st December 2016. Only studies assessing the incidence of new-onset diabetes in subjects treated with ADs were included. Results were pooled using a random-effects meta-analysis. Moreover, we extensively reviewed the role of the different sources of bias that have been proposed to explain the association between AD and diabetes. Twenty studies met the inclusion criteria. In the meta-analysis, the association between AD use and diabetes was still evident after the inclusion of the recent negative studies [pooled relative risk = 1.27, 95% confidence interval (CI), 1.19-1.35; p<0.001]. None of the biases proposed by previous authors seemed able to fully explain the observed association.<h4>Conclusions</h4>This updated meta-analysis confirms the association between AD use and incident diabetes. It still remains a matter of debate whether single ADs exert a different effect on the risk of diabetes. Given the possible heterogeneity, we suggest that a classification of ADs according to their pharmacological profiles could be useful in better elucidating the nature of this association.
format Article
id doaj-art-a35ae4147dd04530b55046acb0b259e9
institution DOAJ
issn 1932-6203
language English
publishDate 2017-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj-art-a35ae4147dd04530b55046acb0b259e92025-08-20T03:24:02ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01127e018208810.1371/journal.pone.0182088The risk of new-onset diabetes in antidepressant users - A systematic review and meta-analysis.Virginio SalviIlaria GruaGiancarlo CerveriClaudio MencacciFrancesco Barone-Adesi<h4>Background</h4>Antidepressant Drugs (ADs) are among the most commonly prescribed medications in developed countries. The available epidemiological evidence suggests an association between AD use and higher risk of developing type 2 diabetes mellitus. However, some methodological issues make the interpretation of these results difficult. Moreover, very recent studies provided conflicting results. Given the high prevalence of both diabetes and AD use in many countries, clarifying whether this association is causal is of extreme relevance for the public health. The aim of the present study is to provide an up-to-date evaluation of the evidence in support of a causal role of ADs in inducing diabetes.<h4>Methods and findings</h4>A systematic literature search was conducted to identify relevant studies in MEDLINE (PubMed), PsycINFO, and International Pharmaceutical Abstracts (IPA) through 31st December 2016. Only studies assessing the incidence of new-onset diabetes in subjects treated with ADs were included. Results were pooled using a random-effects meta-analysis. Moreover, we extensively reviewed the role of the different sources of bias that have been proposed to explain the association between AD and diabetes. Twenty studies met the inclusion criteria. In the meta-analysis, the association between AD use and diabetes was still evident after the inclusion of the recent negative studies [pooled relative risk = 1.27, 95% confidence interval (CI), 1.19-1.35; p<0.001]. None of the biases proposed by previous authors seemed able to fully explain the observed association.<h4>Conclusions</h4>This updated meta-analysis confirms the association between AD use and incident diabetes. It still remains a matter of debate whether single ADs exert a different effect on the risk of diabetes. Given the possible heterogeneity, we suggest that a classification of ADs according to their pharmacological profiles could be useful in better elucidating the nature of this association.https://doi.org/10.1371/journal.pone.0182088
spellingShingle Virginio Salvi
Ilaria Grua
Giancarlo Cerveri
Claudio Mencacci
Francesco Barone-Adesi
The risk of new-onset diabetes in antidepressant users - A systematic review and meta-analysis.
PLoS ONE
title The risk of new-onset diabetes in antidepressant users - A systematic review and meta-analysis.
title_full The risk of new-onset diabetes in antidepressant users - A systematic review and meta-analysis.
title_fullStr The risk of new-onset diabetes in antidepressant users - A systematic review and meta-analysis.
title_full_unstemmed The risk of new-onset diabetes in antidepressant users - A systematic review and meta-analysis.
title_short The risk of new-onset diabetes in antidepressant users - A systematic review and meta-analysis.
title_sort risk of new onset diabetes in antidepressant users a systematic review and meta analysis
url https://doi.org/10.1371/journal.pone.0182088
work_keys_str_mv AT virginiosalvi theriskofnewonsetdiabetesinantidepressantusersasystematicreviewandmetaanalysis
AT ilariagrua theriskofnewonsetdiabetesinantidepressantusersasystematicreviewandmetaanalysis
AT giancarlocerveri theriskofnewonsetdiabetesinantidepressantusersasystematicreviewandmetaanalysis
AT claudiomencacci theriskofnewonsetdiabetesinantidepressantusersasystematicreviewandmetaanalysis
AT francescobaroneadesi theriskofnewonsetdiabetesinantidepressantusersasystematicreviewandmetaanalysis
AT virginiosalvi riskofnewonsetdiabetesinantidepressantusersasystematicreviewandmetaanalysis
AT ilariagrua riskofnewonsetdiabetesinantidepressantusersasystematicreviewandmetaanalysis
AT giancarlocerveri riskofnewonsetdiabetesinantidepressantusersasystematicreviewandmetaanalysis
AT claudiomencacci riskofnewonsetdiabetesinantidepressantusersasystematicreviewandmetaanalysis
AT francescobaroneadesi riskofnewonsetdiabetesinantidepressantusersasystematicreviewandmetaanalysis