Chun-Yuan Lin1,2,3, Yu-Hsin Wu3,4, Hong-Song Wang5, Ping-Kun Chen6,7, Yuan-Fu Lin8, I-Chia Chien2,9. 1. School of Medicine, Chung Shan Medical University, Taichung, Taiwan. 2. Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan. 3. National Changhua University of Education, Changhua, Taiwan. 4. Feng Yuan Hospital, Ministry of Health and Welfare, Taichung, Taiwan. 5. Department of psychiatry, Changhua Hospital, Ministry of Health and Welfare, Chanhua, Taiwan. 6. Department of Neurology, Lin-Shin Hospital, Taichung, Taiwan. 7. School of Medicine, China Medical University, Taichung, Taiwan. 8. College of Management, National Taiwan University, Taipei, Taiwan. 9. Department of Public Health and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
Abstract
BACKGROUND: Second-generation antipsychotics (SGA) augmentation treatment has showed better efficacy in patients with major depressive disorder (MDD). However, the association between SGA and diabetes mellitus (DM) in MDD patients deserves further investigation. The study aimed to examine the risk of new onset type II DM in MDD patients receiving SGA treatment. METHODS: From the Psychiatric Inpatient Medical Claim Dataset, MDD patients treated with SGA continuously for more than 8 weeks were analyzed in a 1:1 propensity score matched pair sample to 1,049 patients that had never been treated with SGA. Patients were followed up to 5 years based on ICD-9 CM codes indicating incident type II DM. Cumulative incidences of type II DM were calculated and the Cox proportional hazards model with competing risk was applied to determine the risk factors for type II DM onset. RESULTS: Cumulative incidences of new-onset type II DM between the two groups were similar. Use of SGA showed no significant increase in risk for new-onset type II DM (hazard ratio [HR] = 0.898; 95% confidence interval [CI], 0.605-1.334; P-value = 0.596). Increased risk for type II DM was shown to be associated with aging (per year) (HR = 1.039; 95% CI, 1.026-1.053; P-value < 0.001) and history of hyperlipidemia (HR = 2.323; 95% CI, 1.469-3.675; P-value < 0.001). CONCLUSIONS: This study indicated that there is no significant difference in the risk of developing type II DM between MDD patients with and without SGA exposure. More studies focused on the benefit-risk assessment of SGA treatment in patients with MDD are warranted.
BACKGROUND: Second-generation antipsychotics (SGA) augmentation treatment has showed better efficacy in patients with major depressive disorder (MDD). However, the association between SGA and diabetes mellitus (DM) in MDDpatients deserves further investigation. The study aimed to examine the risk of new onset type II DM in MDDpatients receiving SGA treatment. METHODS: From the Psychiatric Inpatient Medical Claim Dataset, MDDpatients treated with SGA continuously for more than 8 weeks were analyzed in a 1:1 propensity score matched pair sample to 1,049 patients that had never been treated with SGA. Patients were followed up to 5 years based on ICD-9 CM codes indicating incident type II DM. Cumulative incidences of type II DM were calculated and the Cox proportional hazards model with competing risk was applied to determine the risk factors for type II DM onset. RESULTS: Cumulative incidences of new-onset type II DM between the two groups were similar. Use of SGA showed no significant increase in risk for new-onset type II DM (hazard ratio [HR] = 0.898; 95% confidence interval [CI], 0.605-1.334; P-value = 0.596). Increased risk for type II DM was shown to be associated with aging (per year) (HR = 1.039; 95% CI, 1.026-1.053; P-value < 0.001) and history of hyperlipidemia (HR = 2.323; 95% CI, 1.469-3.675; P-value < 0.001). CONCLUSIONS: This study indicated that there is no significant difference in the risk of developing type II DM between MDDpatients with and without SGA exposure. More studies focused on the benefit-risk assessment of SGA treatment in patients with MDD are warranted.