Diabetes with comorbid depression: Role of SSRI in better glycemic control

Introduction: The presence of depression in patients with diabetes mellitus is reported to be associated with poor glycemic control and an increased risk of diabetic complications. Treatment of depression with selective serotonin reuptake inhibitors (SSRIs) may improve glycemic control and may be beneficial for patients with comorbid depression and diabetes. Aims and objective: To study the effect of Escitalopram (SSRI) in patients with diabetes mellitus with comorbid depression and the relationship of treatment response for depression and glycemic control. Research design and methods: 40 patients received open-label Escitalopram therapy for up to 12 weeks. Clinical outcome measures included Hamilton Depression rating scale (HAM-D) assessment at 3, 6, and 12 weeks. In addition, fasting and post-prandial plasma glucose level, weight and waist circumference, glycosylated hemoglobin level (HbA1C), lipid profile, renal function test and fundus examination were done before and during Escitalopram therapy. Results: A significant decline in mean HAM-D scores was observed 3 weeks onwards till the end of the study during Escitalopram therapy. There was a corresponding decline in mean fasting and post-prandial plasma glucose level at 6 and 12 weeks respectively and glycosylated hemoglobin level at 12 weeks was observed. Conclusion: Escitalopram is effective in treating depression in patients with diabetes mellitus, and has beneficial effects on glycemic control. (C) 2013 Published by Elsevier B.V.