With nearly 20 percent of type 1s and 2s suffering from some form of depressive disorder, depression is an issue of paramount importance for the diabetes community, and one with far-reaching ramifications. The May issue of Diabetes Care reports that a new class of antidepressant agents has just finished its first round of clinical trials, and the results look good.
The study examined 60 patients who had diabetes and a major depressive disorder over the course of eight weeks. The subjects were broken up into two groups and given either a placebo or fluoxetine, an anti-depressant of the new selective serotonin reuptake inhibitor (SSRI) category. Although the dosage began at 20 mg of fluoxetine a day, it was increased to as much as 40 mg if side effects and clinical response permitted.
Of the 54 subjects who completed the study, those taking fluoxetine fared considerably better on two scaled assessments of depression than those taking the placebo. The fluoxetine group also saw a greater rate of actual depression remission than the placebo group.
Not all subjects, however, responded to the fluoxetine treatment, and the researchers urge modifying treatment when needed. Previous studies have found fluoxetine to be less effective in subjects over 60, possibly due to pathological medical conditions that were already present.
Fluoxetine, the only SSRI currently available in the United States, also seemed to have positive effects on HbA1c levels. Depression is already known for having adverse affects on glycemic control, and the study’s authors believe that fluoxetine may play a part in reversing this trend. The drug had demonstrated effects on weight loss, but the researchers concede it is possible fluoxetine affected unmeasured characteristics like insulin action, thereby lowering HbA1c levels.