Existing tendency to develop diabetes in depressed patients isn’t connected with the particular medicine they take.
It is always very interesting to watch how the media pick up on a story from the world of researches in medicine. No matter how well balanced and scientifically neutral the source material may be, it seems that news must always be more sensational. Only the bad news can make marketers smile. Take a headline, “Toothpaste gives you cancer!” Don’t be afraid. I just made that up, but you get the idea. So, as responsible journalists, how should we approach an article in the January edition of Diabetes Research & Clinical Practice? I suppose. Actually approaching it in the first place is difficult because this is hardly a hot-from-the-presses must-read magazine. You actually have to search for research with a magnifying glass. The majority were taking either or both a SSRI like Zoloft or a TCA like Aventyl or Elavil. So let me begin my article with two relevant findings: if you live in Saskatchewan and you are depressed, you are 30% more likely to develop type 2 diabetes than someone who is not depressed; and if you take two medications at the same time, this doubles the likelihood that you will develop diabetes. I can already feel the headlines bubbling up: Living is Saskatchewan is dangerous to your health! Zoloft ate my hamster and got diabetes. The TCAs were first used in the 1950s but, as the newer medications including the SSRIs have come on to the markets, the TCAs have been increasingly phased out because they are considered more likely to cause side effects. Thus, in the period covered by the research, it would not be surprising that patients should be taking both. Either they would be phasing out, say, Moxdil in favor of the newer Zoloft (introduced in 1991) or they were adopting a belt-and-braces approach and combining the old with the new, hoping for the best result. Today, it should be quite unusual to find a significant number of people taking Zoloft and one of the TCAs. But, if you are one of these people, you should stop taking the TCA right now. So let us be absolutely clear on the message here. There is no link in this research between Zoloft and diabetes. Indeed, in the literature, there is a considerable body of evidence to show that the link is more certainly between a depressive illness and diabetes, cardiovascular diseases, etc. The reason is scientific confirmation of a common sense or intuitive truth. So, there is no need to change from Zoloft on the basis of this research, but you still have to watch out for Emperor Zoloft and his hungry-for-hamsters evil empire.