Abstract

A systematic review of depression in Oral antidiabetic agent users

Thanradee Insuwan

Suttita Noiming

Sawaeng Watcharathanakij

Nonglek Kunawaradisai 

Oral antidiabetic agent, Depression, systematic review 

Introduction: Currently, the numbers of depression has been increasingly reported in patients with or without comorbidity.  This is similar to the numbers of new cases diabetes identified.  There is also a rising figure reported the prevalence of depression in diabetic patients.  Both of these conditions show a dramatic effect on quality of patients’ life.  Objective: The purpose of this study was to systematically literature review on the incidence/prevalence/risk of depression in patients receiving oral anti-diabetic agents.  Methods: Journal articles published from 1 April 1968 through 1 November 2019 were systematically searched online from Science-direct, Pubmed, Thaijo and Cochrane databases with search terms “oral anti-diabetic agent and depression”.  Research papers were identified and classified by author, year of publication, country, study design, number of study group, and age of subjects, intervention, outcome measurement and results.  Results: From the total of 963 research articles, 15 papers were included.  From those, there were 10 indicated a relation between depression and oral anti-diabetic agents.  One trial reported that diabetic patients receiving oral anti-hyperglycemic drug were diagnosed with depression by the Norwegian Institute of Public Health and needed antidepressant therapy.  In addition, other studies were undertaken to determine an incidence of depression caused by oral anti-diabetic drug using BDI score, PHQ-9 score, HADS-d score, ICD 9 or ICD 10, WHO-5 score and revealed both significant and non-significant results.  However, 5 published articles interestingly showed the reduction of depressive symptoms significantly from using Piloglitazone and Exenatide.  Conclusion:  From this systematic review, some types of oral anti-hyperglycemic agents are either significantly or non-significantly related to a development of depression.  Some agents such as piloglitazone and exenatide are not.  Therefore, the inconclusive results indicate that more well designed research is needed to develop and a head to head compare the effect of each type of oral anti-diabetic agents on depression is necessary to determine this issue.