Does SSRI Use Increase the Risk of Type 2 Diabetes in Children?

The use of selective serotonin reuptake inhibitors (SSRIs) among children and adolescents is associated with a small increased risk for type 2 diabetes (T2D), according to the results of a recent study.

The researchers conducted a cohort study that included a total of 1,582,914 patients nationwide within the US. All participants were aged 10 to 19 years and were new users of an SSRI medication. To be included in the analysis of those treated with SSRIs, participants needed to have had at least 2 SSRI prescriptions filled.

The participants were sorted into 1 of 2 groups: the publicly insured group (n = 316,178), who were part of the Medicaid Analytic eXtract database that ran from January 2000 to December 2014, or the privately insured group (n = 211,460), who were part of the IBM Marketscan database that ran from January 2003 to September 2015. Participants were followed up for a mean of 2.3 and 2.2 years, respectively.

Comparator groups included those with no antidepressant exposure, bupropion hydrochloride exposure, or psychotherapy exposure. Fluoxetine hydrochloride was used to compare individual SSRI medications.

The results indicated a 13% increased risk of T2D following the initiation of SSRI treatment in publicly insured patients (intention-to-treat adjusted hazard ratio [aHR], 1.13; 95% CI, 1.04-1.22) when compared with untreated patients. Privately insured patients had lower adjusted hazard ratios.

Continuous SSRI treatment was associated with a greater association, corresponding to an additional 6.6 cases of T2D per 10,000 patients who were treated for at least 2 years. SSRI treatment and psychotherapy produced similar results. No increased risk was reported for bupropion treatment between the 2 groups. In addition, there was not an increased risk of T2D for any medication compared with fluoxetine for the within-class analysis.

“These findings suggest that children and adolescents initiating SSRI treatment may be at a small increased risk of developing T2D, particularly publicly insured patients,” the researchers concluded. “The magnitude of association was more modest than previously reported, and the absolute risk was small. The potential small risk should be viewed in relation to the efficacy of SSRIs for its major indications in young patients.”

—Leigh Precopio

Reference:

Sun JW, Hernández-Díaz S, Haneuse S, et al. Association of selective serotonin reuptake inhibitors with the risk of type 2 diabetes in children and adolescents. JAMA Psychiatry. 2021;78(1):91-100. doi: 10.1001/jamapsychiatry.2020.2762