Antidepressants extend time to relapse in diabetics
NEW YORK (Reuters Health) – Maintenance treatment with the
antidepressant sertraline (Zoloft) after a first episode of
depression has resolved extends the time to relapse in patients
with diabetes, study results suggest. And sustained remission
of depression is associated with improved control of blood
Depression is highly prevalent among patients with
diabetes, Dr. Patrick J. Lustman, from Washington University
School of Medicine in St. Louis, and colleagues note, and
recurrence after initial successful treatment is common.
Depression, in turn, is linked to increased morbidity and
mortality among diabetics, they point out in the Archives of
General Psychiatry for May.
Previous studies have been limited to no more than 16 weeks
of treatment, the authors report. The goal of the current study
was to see if continued antidepressant treatment beyond the
first remission would be effective in prolonging
depression-free periods and improving glycemic (blood sugar)
In the first phase of the study, 351 diabetic patients with
moderately severe and recurrent major depression were treated
with Zoloft, up to 200 mg/day for 16 weeks. Recovery occurred
in 156 (44 percent).
The second phase of the trial included 152 diabetics from
the first group who were successfully treated for depression.
Seventy-nine were randomly assigned to continued Zoloft and 73
Zoloft was significantly more successful than placebo in
prolonging the depression-free interval, report the
investigators. Time to recurrence in one third of patients was
57 days in the placebo group and 226 days in the Zoloft group.
During the second phase of the trial, changes in HbA1c
level — a marker of blood sugar control — did not differ
between groups. However, HbA1c levels were significantly lower
than baseline during depression-free periods, regardless of
According to Lustman’s group: “Vigilant monitoring of
depression symptoms to prompt treatment augmentation or
modification is required and may improve the picture.” They
also suggest that psychotherapy may help provide more durable
relief of depression.
SOURCE: Archives of General Psychiatry May 2006.