Study 3 is a prospective follow-up of self-reported weight change between baseline survey in 2000–2002 and follow-up survey in 2004–2005 for all identified 1,404 antidepressant users participating in the surveys and their 4,133 matched control subjects (nonusers) (supplementary eFig. Because the benefits of antidepressant therapy may be substantial only for patients with severe depression ( 3), we also examined the antidepressant-diabetes association separately in this group and among those with mild or moderate symptoms. Accordingly, the aim of this study is to examine whether exposure to antidepressant medication use is associated with type 2 diabetes risk in a large population of men and women (Aim 1) and whether there is a difference in weight gain among antidepressant users compared with equally depressed individuals who are not treated with antidepressants (Aim 2). In addition, participants' responses to surveys at study baseline and follow-up enable determining change in self-reported weight over time. Study members in the present epidemiological cohort have been linked to complete national pharmacy records from which the daily dose of antidepressant medication, based on World Health Organization (WHO) definitions of average maintenance dose ( 15), can be captured. Separate analyses for tricyclic antidepressants and selective serotonin reuptake inhibitors replicated these findings. An average self-reported weight gain, based on repeated surveys, was 1.4 kg (2.5%) among nonusers and 2.5 kg (4.3%) among users of ≥200 defined daily doses ( P trend < 0.0001). The 5-year absolute risk of diabetes was 1.1% for nonusers, 1.7% for individuals treated with 200–399 defined daily doses a year, and 2.3% for those with ≥400 defined daily doses ( P trend < 0.0001). In further analyses, the exposed group was antidepressant users and the reference group was nonusers matched for depression-related characteristics. Antidepressant use of ≥200 defined daily doses was associated with a doubling of diabetes risk in both participants with no indication of severe depression (odds ratio 1.93 ) and participants with severe depression (2.65 ). In the first analysis, the case subjects were individuals with incident type 2 diabetes compared with matched diabetes-free control subjects.

Atc code n06ax