The tendency to develop diabetes in depressed patients isn’t connected with the particular medicine they take.
It doesn’t matter how well balanced and scientifically neutral the source material may be, news are often much more sensational than you can suppose. Only bad news is good news to sell newspapers and keep the advertisers happy. It is always fascinating to watch how the media pick up on a story from the world of medical research. So, as responsible journalists, how should we approach an article in the January edition of Diabetes Research & Clinical Practice? Well, I jest, of course. 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 be searching for research with a magnifying glass. Brown, Mujumdar and Johnson had the data on the incidence of type 2 diabetes from 1st January, 1991 to 31st December, 2001 among patients who were depressed. Anyway, the authors beat the grasses with a stick in the Canadian province of Saskatchewan to see what snakes would come out. The majority were taking either or both a Selective Serotonin Reuptake Inhibitors (SSRI) like Zoloft or a tricyclic antidepressant (TCA) like Aventyl or Elavil.
I can already feel the headlines bubbling up: Living is Saskatchewan is dangerous to your health! Zoloft ate my hamster and got diabetes (a reference to the Evil Emperor Zoloft who rules over the Milky Way except our bit and deserves to suffer retribution for all his evil doings). 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 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. That people who are depressed do not look after themselves with the same care and attention as “healthy” people.