A study published in the Archives of General Psychiatry has now revealed that the risk of recurrent depression in diabetics may be effectively prevented by the antidepressant medication, Sertraline. In addition to reducing the frequency of depressive episodes, the drug has also been found to increase the time interval between episodes of depression in diabetics.
It is believed that one in 4 diabetics end up with a diagnosis of clinical depression, leading to a substantial reduction in the quality of life and functional ability. In addition, it can increase the risk of high blood sugar level, diabetic complications and even death.
Conventional treatment with psychotherapy and anti-depressant medication has been found to be effective. However, this is only useful in short term. Furthermore, previous studies have shown that 1 in 7 diabetic patients developed resistance to the commonly used anti-depressant medication owing to incidence of recurrent depression, placing them at an increased risk for abnormally high blood sugar levels.
The researchers included 152 diabetics, all of whom had recovered from their first bout of depression following treatment with sertraline. The study participants were followed for a minimum of one year or till such time their depression recurred. During the same time, they were randomly assigned into two groups; with the experimental group receiving sertraline while the control group received a placebo instead.
Following detection of depression associated symptoms; the patients underwent a psychiatric interview. The patients' hemoglobin levels, more specifically Hb A1c, an indicator of the blood glucose control level over the past two or three months was measured every two months.
At the end of the study, patients taking sertraline had a reduced risk of developing recurrent depression when compared to their counterparts. At the end of one year, 65.8% of the patients taking sertraline remained in remission from their depression, compared with 47.9% of those in the control group. The time interval between recurrent episodes of depression was found to be 226 days and 57 days in the sertraline and the control group respectively.
'Using data available at the one-year point, the number needed to be treated was six patients, i.e., it would be necessary to treat six patients to spare one patient from depression recurrence,' the authors write. All participants' Hb A1c levels had decreased when they recovered from depression and remained lower as long as they remained depression-free, with no difference between the two study groups. Depression is increasingly understood as a recurrent and debilitating disease, especially for those with diabetes, the authors write. Physicians suspect that the more time an individual spends depressed, the greater the risk for diabetic complications and death. 'Our study establishes a clear benefit of sertraline for prevention of depression recurrence in patients with diabetes,' remarked the study authors.
'Sertraline lengthened the depression-free interval of maintenance and did not interfere with glycemic improvement achieved during the recovery phase. 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,' concluded the researchers.