While diabetes and depression are not directly linked, studies show that diabetics may be at risk for developing depression at some point. Diabetes can be a stressful disease due to the major lifestyle changes many patients have to make to control their blood glucose levels.
It can be difficult choosing medications for treatment of comorbid depression in diabetes. Many diabetes medications, such as tricyclic antidepressants and MAOIs, can cause blood sugar fluctuations. SSRIs are usually prescribed because they are considered the safest for those with diabetes, but which ones are most commonly prescribed?
Paroxetine, commonly prescribed as Paxil, is an SSRI that may be prescribed to diabetic patients experiencing depression. It helps maintain mental balance through increasing serotonin. There are at least two dozen common side effects, such as headache, weakness, dizziness, feeling “drugged”, stomach pain, constipation or diarrhea, dry mouth, nausea, heartburn and others.
Tell your doctor about any medical conditions, such as heart attack, seizures, esophageal or stomach bleeding, heart disease, glaucoma or kidney or liver disease. If you take St. John's wort or tryptophan, you may not be able to take this medication.
Other medications that may interact include blood thinners, antidepressants, non-steroidal anti-inflammatory drugs, cough medications, heart medications, anti-anxiety medications, diuretics, irregular heart beat medications, anti-psychotic medications, pain medications, other heart medications, sleeping medications and sometimes other medications.
Fluoxetine, also prescribed as Paxil, is a commonly prescribed SSRI for diabetes patients. It works in the same way as paroxetine, by increasing serotonin to help the patient maintain mental balance. Common side effects may include weight loss, appetite loss, nausea, sore throat, weakness, sexual changes, nervousness, dry mouth, drowsiness, a part of the body shaking uncontrollably or excessive sweating.
St. John's Wort and tryptophan should not be taken with this drug. Those who are pregnant, undergoing electroshock therapy, who have had a heart attack, and those with heart disease, liver disease or seizures should tell their doctor.
Other medications that may interact include MAO inhibitors, anti-anxiety drugs, blood thinners, non-steroidal anti-inflammatory drugs, diabetes medications, diuretics, other antidepressants, other mental illness medications, anti-seizure medications, tranquilizers and certain other medications.
Sertraline, also prescribed as Zoloft, is another one of the SSRI medications for treatment of comorbid depression in diabetes. It also increases serotonin levels which is often beneficial in maintaining mental balance. Common side effects may include nausea, weight changes, excessive sweating, constipation, dry mouth, fatigue, headache, and some patients may experience other side effects.
Pregnancy, seizures, heart or liver disease, and a history of heart attacks should be reported to the patient's doctor.
Other medications may interact including MAO inhibitors, Antabuse, blood thinners, non-steroidal anti-inflammatory drugs, medications for mental illnesses, anti-seizure medications, antidepressants, irregular heartbeat medications, migraine medications, sedatives and sleeping medications, and, in some cases, other medications.
American Diabetes Association. (2011). Depression. Retrieved on February 16, 2011 from the American Diabetes Association: https://www.diabetes.org/living-with-diabetes/complications/mental-health/depression.html#%22
Mayo Clinic. (2010). Selective Serotonin Reuptake Inhibitors (SSRIs). Retrieved on February 16, 2011 from the Mayo Clinic: https://www.mayoclinic.com/health/ssris/MH00066