International Journal of Clinical Pharmacy

, Volume 34, Issue 3, pp 432–438 | Cite as

RETRACTED ARTICLE: Use of antidepressants and the risk of type 2 diabetes mellitus: a nested case–control study

  • Star KhozaEmail author
  • Jamie C. Barner
  • Thomas M. Bohman
  • Karen Rascati
  • Kenneth Lawson
  • James P. Wilson
Research Article


Background Recent evidence from case reports, observational studies, and randomized trials suggests that long-term use of antidepressants increases the risk of developing diabetes. However, the nature of the relationship between antidepressants and diabetes remains unclear. Objective To determine whether there is an association between antidepressant use and the risk of developing type 2 diabetes mellitus. Methods A nested case–control study using the Texas Medicaid prescription claims database was conducted. Data were extracted for new users of either antidepressant agents (exposed) or benzodiazepines (unexposed) from January 1, 2002 through December 31, 2009. Patients aged 18–64 years without a history of diabetes were included in the cohort. The adjusted odds ratio (OR) and 95% confidence interval (CI) for the risk of diabetes associated with antidepressant exposure was computed using conditional logistic regression, controlling for demographic and clinical covariates. Main outcome measure Development of type 2 diabetes mellitus Results Among the total sample (N = 44,715), the majority were in the exposed (N = 35,552) vs. the unexposed (N = 9,163) group. A total of 2,943 cases of type 2 diabetes mellitus and 11,748 matched controls (1:4) were identified using risk-set sampling. Cases and controls were matched using age and gender. Antidepressant use was associated with an increase in the risk of (type-2) diabetes when compared to benzodiazepine use [Adjusted Odds Ratio (OR) = 1.512; 95% CI 1.345–1.700]. The association was observed with serotonin-norepinephrine reuptake inhibitors (OR = 1.742; 95% CI 1.472–2.060), tricyclic antidepressants (OR = 1.533; 95% CI 1.295–1.814), selective serotonin reuptake inhibitors (OR = 1.457; 95% CI 1.279–1.659), “Other” antidepressants (OR = 1.318; 95% CI 1.129–1.540). Conclusions Antidepressant use was associated with an increased risk of (type-2) diabetes. This association was observed for tricyclic antidepressants, serotonin-reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and other antidepressants.


Antidepressants Diabetes Diabetes type-2 Medicaid Nested case–control study Prescriptions claim database Texas United States 



The authors would like to thank the Texas Department of Health and Human Services for providing the Texas Medicaid data used in this study. In addition, the authors are grateful to Dr. KM Richards for help with data extraction.


This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Conflicts of interest

The authors have no conflict of interest to declare.


  1. 1.
    Winer N, Sowers JR. Epidemiology of diabetes. J Clin Pharmacol. 2004;44(4):397–405.PubMedCrossRefGoogle Scholar
  2. 2.
    Anderson RN, Smith BL. Deaths: leading causes for 2001. Natl Vital Stat Rep. 2003;52(9):1–85.Google Scholar
  3. 3.
    Andersohn F, Schade R, Suissa S, Garbe E. Long-term use of antidepressants for depressive disorders and the risk of diabetes mellitus. Am J Psychiatry. 2009;166(5):591–8.PubMedCrossRefGoogle Scholar
  4. 4.
    Brown LC, Majumdar SR, Johnson JA. Type of antidepressant therapy and risk of type 2 diabetes in people with depression. Diabetes Res Clin Pract. 2008;79(1):61–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Kivimaki M, Hamer M, Batty GD, Geddes JR, Tabak AG, Pentti J, et al. Antidepressant medication use, weight gain, and risk of type 2 diabetes: a population-based study. Diabetes Care. 2010;33(12):2611–6.PubMedCrossRefGoogle Scholar
  6. 6.
    Kivimaki M, Tabak AG, Lawlor DA, Batty GD, Singh-Manoux A, Jokela M, et al. Antidepressant use before and after the diagnosis of type 2 diabetes: a longitudinal modeling study. Diabetes Care. 2010;33(7):1471–6.PubMedCrossRefGoogle Scholar
  7. 7.
    Raeder MB, Bjelland I, Vollset SE, Steen VM. Obesity, dyslipidemia, and diabetes with selective serotonin reuptake inhibitors: the Hordaland health study. J Clin Psychiatry. 2006;67(12):1974–82.PubMedCrossRefGoogle Scholar
  8. 8.
    Rubin RR, Ma Y, Marrero DG, Peyrot M, Barrett-Connor EL, Kahn SE, et al. Elevated depression symptoms, antidepressant medicine use, and risk of developing diabetes during the diabetes prevention program. Diabetes Care. 2008;31(3):420–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Rubin RR, Ma Y, Peyrot M, Marrero DG, Price DW, Barrett-Connor E, et al. Antidepressant medicine use and risk of developing diabetes during the diabetes prevention program and diabetes prevention program outcomes study. Diabetes Care. 2010;33(12):2549–51.PubMedCrossRefGoogle Scholar
  10. 10.
    Atlantis E, Browning C, Sims J, Kendig H. Diabetes incidence associated with depression and antidepressants in the melbourne longitudinal studies on healthy ageing (MELSHA). Int J Geriatr Psychiatry. 2009;25:688–96.CrossRefGoogle Scholar
  11. 11.
    Knol MJ, Geelings MI, Egberts AC, Gorter KJ, Grobbee DE, Heerdink ER. No increased incidence of diabetes in antidepressant users. Int Clin Psychopharmacol. 2007;22:382–6.PubMedCrossRefGoogle Scholar
  12. 12.
    NIHCM Foundation. Prescription drug expenditure in 2001: another year of escalating costs. 2001 [cited 2009 July 9].Google Scholar
  13. 13.
    Mojtabai R, Olfson M. National patterns in antidepressant treatment by psychiatrists and general medical providers: results from the national comorbidity survey replication. J Clin Psychiatry. 2008;69(7):1064–74.PubMedCrossRefGoogle Scholar
  14. 14.
    Centers for disease control and prevention. Diabetes Fact Sheet 2007. Atlanta, GA2007 [10/31/2009]; Available from:
  15. 15.
    Texas health and human services. Texas medicaid and CHIP in perspective. Texas health and human Services; 2009 [cited 2010 Feb 4]; Seventh Edition:[Available from:
  16. 16.
    Patel NC, Crismon ML, Hoagwood K, Johnsrud MT, Rascati KL, Wilson JP, et al. Trends in the use of typical and atypical antipsychotics in children and adolescents. J Am Acad Child Adolesc Psychiatry. 2005;44(6):548–56.PubMedCrossRefGoogle Scholar
  17. 17.
    Rascati KL, Stanford RH, Borker R. A comparison of the risk of hospitalizations due to chronic obstructive pulmonary disease in medicaid patients with various medication regimens, including ipratropium, inhaled corticosteroids, salmeterol, or their combination. Clin Ther. 2005;27(3):346–54.PubMedCrossRefGoogle Scholar
  18. 18.
    Opolka JL, Rascati KL, Brown CM, Gibson PJ. Ethnicity and prescription patterns for haloperidol, risperidone, and olanzapine. Psychiatr Serv. 2004;55(2):151–6.PubMedCrossRefGoogle Scholar
  19. 19.
    Smith MJ, Rascati KL, McWilliams BC. Inhaled anti-inflammatory pharmacotherapy and subsequent hospitalizations and emergency department visits among patients with asthma in the Texas medicaid program. Ann Allergy Asthma Immunol. 2004;92(1):40–6.PubMedCrossRefGoogle Scholar
  20. 20.
    Barner JC, Worchel J, Yang M. Frequency of new-onset diabetes mellitus and use of antipsychotic drugs among central Texas veterans. Pharmacother. 2004;24(11):1529–38.CrossRefGoogle Scholar
  21. 21.
    Yang M, Barner JC, Worchel J. Factors related to antipsychotic oversupply among central Texas veterans. Clin Ther. 2007;29(6):1214–25.PubMedCrossRefGoogle Scholar
  22. 22.
    Etminan M, Streiner DL, Rochon PA. Exploring the association between atypical neuroleptic agents and diabetes mellitus in older adults. Pharmacother. 2003;23(11):1411–5.CrossRefGoogle Scholar
  23. 23.
    Sclar DA, Chin A, Skaer TL, Okamoto MP, Nakahiro RK, Gill MA. Effect of health education in promoting prescription refill compliance among patients with hypertension. Clin Ther. 1991;13(4):489–95.PubMedGoogle Scholar
  24. 24.
    Dailey G, Kim MS, Lian JF. Patient compliance and persistence with antihyperglycemic drug regimens: evaluation of a medicaid patient population with type 2 diabetes mellitus. Clin Ther. 2001;23(8):1311–20.PubMedCrossRefGoogle Scholar
  25. 25.
    Henderson DC, Cagliero E, Gray C, Nasrallah RA, Hayden DL, Schoenfeld DA, et al. Clozapine, diabetes mellitus, weight gain, and lipid abnormalities: a five-year naturalistic study. Am J Psychiatry. 2000;157(6):975–81.PubMedCrossRefGoogle Scholar
  26. 26.
    Pandit MK, Burke J, Gustafson AB, Minocha A, Peiris AN. Drug-induced disorders of glucose tolerance. Ann Intern Med. 1993;118(7):529–39.PubMedGoogle Scholar
  27. 27.
    Luna B, Feinglos MN. Drug-induced hyperglycemia. JAMA. 2001;286(16):1945–8.PubMedCrossRefGoogle Scholar
  28. 28.
    Von Korff M, Wagner EH, Saunders K. A chronic disease score from automated pharmacy data. J Clin Epidemiol. 1992;45(2):197–203.CrossRefGoogle Scholar
  29. 29.
    Derijks HJ, Meyboom RH, Heerdink ER, De Koning FH, Janknegt R, Lindquist M, et al. The association between antidepressant use and disturbances in glucose homeostasis: evidence from spontaneous reports. Eur J Clin Pharmacol. 2008;64(5):531–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Star Khoza
    • 1
    Email author
  • Jamie C. Barner
    • 2
  • Thomas M. Bohman
    • 3
  • Karen Rascati
    • 2
  • Kenneth Lawson
    • 2
  • James P. Wilson
    • 2
  1. 1.Department of Clinical PharmacologyCollege of Health Sciences, University of ZimbabweHarareZimbabwe
  2. 2.College of Pharmacy, The University of Texas at AustinAustinUSA
  3. 3.School of Social Work, The University of Texas at AustinAustinUSA

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