Original Paper

Safety and Efficacy of s-Citalopram in Patients with Co-Morbid Major Depression and Diabetes Mellitus
Jay D. Amsterdam^a, Justine Shults^{a, b}, Nancy Rutherford^a, Stanley Schwartz<sup>c

a</sup>Depression Research Unit, Department of Psychiatry,
^bCenter for Clinical Epidemiology and Bio-Statistics, and
^cDepartment of Internal Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pa., USA

Address of Corresponding Author

Neuropsychobiology 2006;54:208-214 (DOI: 10.1159/000100369)

  Key Words

• Diabetes mellitus
• Glycosylated hemoglobin
• Major depressive disorder
• s-Citalopram
• Selective serotonin reuptake inhibitor

  Abstract

Objective: The presence of co-morbid depressive symptoms may have a negative impact on the management of diabetes mellitus. Moreover, some antidepressants may adversely affect glycemic control. Selective serotonin reuptake inhibitors (SSRIs) may improve glycemic control and may be beneficial for patients with co-morbid depression and diabetes. We examined the safety and efficacy of s-citalopram therapy in patients with co-morbid depression and diabetes, and its ability to improve glycemic control. Research Design and Methods: 17 patients were enrolled into the trial and 14 patients received open-label s-citalopram therapy for up to 16 weeks. Clinical outcome measures included the 17-item Hamilton depression rating (HAM-D 17) and the clinical global impressions severity (CGI/S) and change (CGI/C) ratings. In addition, fasting glucose, fructosamine, and glycosylated hemoglobin-A_1C measures were obtained before and during s-citalopram therapy. Results: We observed a significant reduction in mean HAM-D 17 (p < 0.001), CGI/S (p = 0.001) and CGI/C (p = 0.001) ratings during s-citalopram therapy. We also observed a modest, non-significant reduction in fasting glucose, fructosamine, and glycosylated hemoglobin-A_1C levels during s-citalopram therapy. Limitation: Limitations of this study include a modest patient sample size and a 16-week treatment duration which may have been insufficient to demonstrate the full effect of SSRI therapy on glycemic control. Conclusion: We observed a significant reduction in depressive symptoms and modest, non-significant reductions in fasting glucose, fructosamine, and glycosylated hemoglobin-A_1C levels during SSRI therapy of co-morbid depression and diabetes.

Copyright © 2006 S. Karger AG, Basel

  Author Contacts

Jay D. Amsterdam, MD
Depression Research Unit
University Science Center, 3rd Floor, 3535 Market Street
Philadelphia, PA 19104-3309 (USA)
Tel. +1 215 662 3462, Fax +1 215 662 6443, E-Mail jamsterd@mail.med.upenn.edu

  Article Information

Received: July 20, 2006
Accepted after revision: December 17, 2006
Published online: March 2, 2007
Number of Print Pages : 7
Number of Figures : 0, Number of Tables : 0, Number of References : 51