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3 May 2006
Maintenance antidepressant medication can prevent depression from recurring among patients with diabetes, study findings show.
Clinical depression is present in one of every four patients with Type 1 or Type 2 diabetes and can adversely affect medical prognosis and lessen the quality of life of affected patients, Patrick Lustman (Washington University School of Medicine, St Louis, Missouri, USA) and colleagues note in the Archives of General Psychiatry.
With sertraline maintenance treatment, however, they found that the time that elapsed before one third of patients experienced recurrence was almost four times longer than that for patients given placebo.
For their study, the researchers randomly assigned 152 patients aged an average of 52.8 years, who had recovered from depression using sertraline in an open-label trial, to either continue receiving sertraline or switch to placebo in a double-blind study.
During the 52-week trial, the patients visited a physician every month and were contacted by telephone every 2 weeks to screen for symptoms of depression. If symptoms were detected, they underwent a psychiatric interview. The patient's hemoglobin levels were also measured every 2 months to determine blood glucose control.
After 1 year, the proportion of patients who had not experienced a recurrence of their depression was 65.8% among patients taking sertraline, compared with 47.9% among placebo-treated individuals. This corresponds to six people needing to be treated with sertraline in order to prevent depression recurrence in one patient.
In one-third of patients, the time to recurrence increased from 57 days in patients given placebo to 226 days for patients treated with sertraline.
The researchers also note in the Archives of General Psychiatry that hemoglobin levels decreased in patients during the period of depression recovery and remained low during maintenance treatment as long as the patients were free of depression, with no significant difference between the two groups.
"Our study establishes a clear benefit of sertraline for prevention of depression recurrence in patients with diabetes," Lustman et al write.
"Sertraline lengthened the depression-free interval of maintenance and did not interfere with glycemic improvement achieved during the recovery phase."
They conclude: "Treatment with sertraline is relatively simple, safe, and widely available, and although it is not curative, it offers patients with diabetes a potentially viable method for ameliorating the suffering, incapacity, and burden associated with recurrent depression."
Source: Arch Gen Psychiatry 2006; 63: 521–529
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