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使用各种抗抑郁药的患者与使用氟西汀的患者相比患2型糖尿病的短期风险。

Short-Term Risk of Type 2 Diabetes in Patients Using Various Antidepressants Compared with Patients Using Fluoxetine.

作者信息

Kim Hee-Cheol

机构信息

Department of Psychiatry, Keimyung University School of Medicine, Daegu, Korea.

Brain Research Institute, Keimyung University School of Medicine, Daegu, Korea.

出版信息

Psychiatry Clin Psychopharmacol. 2024 Nov 28;34(4):294-301. doi: 10.5152/pcp.2024.24917.

DOI:10.5152/pcp.2024.24917
PMID:39629756
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11744381/
Abstract

BACKGROUND

The objective is to compare the risk of developing type 2 diabetes (T2D) within a year in patients prescribed various antidepressants (ADs) and those prescribed fluoxetine as a control group.

METHODS

This study used standardized data from the Health Insurance Review and Assessment Service claims database (n=1,456,489). Patients aged ≥10 years with no previous use of ADs and no history of diabetes mellitus, regardless of whether they were diagnosed with any depressive disorder, were eligible for this study. Among these eligible patients, those who had used ADs for the first time or had never used them between January 2017 and December 2017 were selected for this study. I compared the short-term (<12 months) risk of T2D in patients using various ADs, excluding tricyclic ADs, with those using fluoxetine as a control. The Cox proportional hazards model was used to calculate hazard ratios (HRs).

RESULTS

The HRs (95% confidence intervals) for T2D incidence in the various AD groups compared with that in the fluoxetine group are as follows: 0.84 (0.67-1.06, P = .15), bupropion; 0.91 (0.77- 1.07, P=.25), tianeptine; 0.91 (0.77-1.07, P=.25), escitalopram; 0.96 (0.82-1.13, P = .63), paroxetine; 0.97 (0.70-1.35, P=.87), fluvoxamine; 1.07 (0.85-1.36, P=.55), vortioxetine; 1.07 (0.91-1.25, P=.42), sertraline; 1.14 (0.99-1.31, P = .07), duloxetine; 1.17 (0.97-1.41, P = .09), mirtazapine; 1.17 (1.00-1.38, P=.05), trazodone; 1.22 (1.04-1.45, P=.02), venlafaxine; and 1.29 (1.03-1.61, P = .03), milnacipran.

CONCLUSION

The short-term risk of T2D was significantly higher in the milnacipran and venlafaxine groups than in the fluoxetine group. All other ADs except milnacipran and venlafaxine showed no difference in the risk of developing T2D compared to fluoxetine. These results suggest that clinicians should be mindful of the risk of developing T2D when administering milnacipran and venlafaxine to patients.

摘要

背景

目的是比较使用各种抗抑郁药（ADs）的患者与使用氟西汀作为对照组的患者在一年内患2型糖尿病（T2D）的风险。

方法

本研究使用了健康保险审查和评估服务索赔数据库中的标准化数据（n = 1,456,489）。年龄≥10岁、既往未使用过ADs且无糖尿病病史的患者，无论是否被诊断患有任何抑郁症，均符合本研究条件。在这些符合条件的患者中，选择在2017年1月至2017年12月期间首次使用ADs或从未使用过ADs的患者进行本研究。我比较了使用各种ADs（不包括三环类ADs）的患者与使用氟西汀作为对照的患者患T2D的短期（<12个月）风险。使用Cox比例风险模型计算风险比（HRs）。

结果

与氟西汀组相比，各AD组T2D发病率的HRs（95%置信区间）如下：安非他酮，0.84（0.67 - 1.06，P = 0.15）；噻奈普汀，0.91（0.77 - 1.07，P = 0.25）；艾司西酞普兰，0.91（0.77 - 1.07，P = 0.25）；帕罗西汀，0.96（0.82 - 1.13，P = 0.63）；氟伏沙明，0.97（0.70 - 1.35，P = 0.87）；伏硫西汀，1.07（0.85 - 1.36，P = 0.55）；舍曲林，1.07（0.91 - 1.25，P = 0.42）；度洛西汀，1.14（0.99 - 1.31，P = 0.07）；米氮平，1.17（0.97 - 1.41，P = 0.09）；曲唑酮，1.17（1.00 - 1.38，P = 0.05）；文拉法辛，1.22（1.04 - 1.45，P = 0.02）；米那普明，1.29（1.03 - 1.61，P = 0.03）。

结论

米那普明和文拉法辛组患T2D的短期风险显著高于氟西汀组。除米那普明和文拉法辛外，所有其他ADs与氟西汀相比，患T2D的风险无差异。这些结果表明，临床医生在给患者使用米那普明和文拉法辛时应注意患T2D的风险。

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