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Antidepressant and antipsychotic drug prescribing and diabetes outcomes: A systematic review of observational studies

Greene, Charlotte RL; Ward-Penny, Hanna; Ioannou, Marianna F; Wild, Sarah H; Wu, Honghan; Smith, Daniel J; Jackson, Caroline A; (2023) Antidepressant and antipsychotic drug prescribing and diabetes outcomes: A systematic review of observational studies. Diabetes Research and Clinical Practice , 199 , Article 110649. 10.1016/j.diabres.2023.110649. Green open access

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Abstract

AIMS: Psychotropic medication may be associated with adverse effects, including among people with diabetes. We conducted a systematic review of observational studies investigating the association between antidepressant or antipsychotic drug prescribing and type 2 diabetes outcomes. METHODS: We systematically searched PubMed, EMBASE, and PsycINFO to 15th August 2022 to identify eligible studies. We used the Newcastle-Ottawa scale to assess study quality and performed a narrative synthesis. RESULTS: We included 18 studies, 14 reporting on antidepressants and four on antipsychotics. There were 11 cohort studies, one self-controlled before and after study, two case-control studies, and four cross-sectional studies, of variable quality with highly heterogeneous study populations, exposure definitions, and outcomes analysed. Antidepressant prescribing may be associated with increased risk of macrovascular disease, whilst evidence on antidepressant and antipsychotic prescribing and glycaemic control was mixed. Few studies reported microvascular outcomes and risk factors other than glycaemic control. CONCLUSIONS: Studies of antidepressant and antipsychotic drug prescribing in relation to diabetes outcomes are scarce, with shortcomings and mixed findings. Until further evidence is available, people with diabetes prescribed antidepressants and antipsychotics should receive monitoring and appropriate treatment of risk factors and screening for complications as recommended in general diabetes guidelines.

Type: Article
Title: Antidepressant and antipsychotic drug prescribing and diabetes outcomes: A systematic review of observational studies
Location: Ireland
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.diabres.2023.110649
Publisher version: https://doi.org/10.1016/j.diabres.2023.110649
Language: English
Additional information: © 2023 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Antidepressant medication, Antipsychotic medication, Diabetes complications, Diabetes mellitus, Diabetes outcomes, Systematic review
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
URI: https://discovery.ucl.ac.uk/id/eprint/10168289
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