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Prescription of Antidepressants or Antipsychotics Common Before Diabetes Diagnosis

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Prescription of Antidepressants or Antipsychotics Common Before Diabetes Diagnosis

People with newly diagnosed diabetes were often already taking an antidepressant or antipsychotic drug, according to a new study presented at the 2021 meeting of the European Association for the Study of Diabetes, and described in an article at HealthDay.

It has long been known that people with diabetes are at increased risk for depression, but the reasons for this connection aren’t fully understood. It has also been shown recently that even people with prediabetes are at greater risk for major depression, indicating that the risk for depression increases along with blood glucose levels even before glucose is high enough for a diabetes diagnosis.

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For the latest study, researchers at the University of Edinburgh in Scotland looked at patterns of prescriptions for antidepressant and antipsychotic drugs in the years before a diabetes diagnosis. Out of 266,186 adults with type 2 diabetes, in the four years prior to their diabetes diagnosis, 22.5% were prescribed an antidepressant, 5.3% were prescribed an antipsychotic, and 6.6% were prescribed both types of drugs. Among those who were prescribed antidepressants, 32.9% of these prescriptions were for a selective serotonin reuptake inhibitor (SSRI), 30.5% were for a tricyclic antidepressant, 9.9% were for a different type of antidepressant, and 26.8% were for multiple types of antidepressants. Among those who were prescribed antipsychotics, 80.4% of these prescriptions were for a first-generation antipsychotic, 14.2% were for a second-generation antipsychotic, and 5.5% were for multiple types of antipsychotics.

Compared with participants who weren’t prescribed an antidepressant or antipsychotic, participants who took at least one of these drugs in the four years prior to a diabetes diagnosis were more likely to be women, to live in socioeconomically deprived areas, to be current smokers, to be obese, to have high blood pressure, and to have high total blood cholesterol. Not surprisingly, they were also more likely to have been admitted to a hospital for a psychiatric disorder.

While the researchers found that taking an antidepressant or antipsychotic was fairly common in the years before a diabetes diagnosis, this does not indicate that such drugs played a role in the development of diabetes. It’s possible that underlying biological changes contributed to developing both mental health disorders and diabetes, and that mental health disorders tended to be diagnosed first. And regardless of the causes of diabetes or mental health disorders, it’s important for doctors to know as much as possible about how treating diabetes may need to look different in people who take an antidepressant or antipsychotic.

“Further work is needed to investigate prescription patterns post-diabetes diagnosis,” the researchers wrote, “and to determine whether use of these drugs influences the risk of macrovascular and microvascular complications of type 2 diabetes.”

Want to learn more about diabetes and mental health? Read “Dealing With Diabetes and Depression” and “Diabetes and Mental Health.”

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