Antidepressant and antipsychotic drug prescribing and diabetes outcomes: a systematic review of observational studies

Charlotte Greene, Hanna Ward-Penny, Marianna F Ioannou, Sarah H Wild, Honghan Wu, Daniel Smith, Caroline A Jackson*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Psychotropic medication may be associated with adverse effects, including among people with diabetes. We conducted a systematic review of observational studies investigating the association between antidepressant or antipsychotic drug prescribing and type 2 diabetes outcomes.
We systematically searched PubMed, EMBASE, and PsycINFO to 15th August 2022 to identify eligible studies. We used the Newcastle-Ottawa scale to assess study quality and performed a narrative synthesis.
We included 18 studies, 14 reporting on antidepressants and four on antipsychotics. There were 11 cohort studies, one self-controlled before and after study, two case-control studies, and four cross-sectional studies, of variable quality with highly heterogeneous study populations, exposure definitions, and outcomes analysed. Antidepressant prescribing may be associated with increased risk of macrovascular disease, whilst evidence on antidepressant and antipsychotic prescribing and glycaemic control was mixed. Few studies reported microvascular outcomes and risk factors other than glycaemic control.
Studies of antidepressant and antipsychotic drug prescribing in relation to diabetes outcomes are scarce, with shortcomings and mixed findings. Until further evidence is available, people with diabetes prescribed antidepressants and antipsychotics should receive monitoring and appropriate treatment of risk factors and screening for complications as recommended in general diabetes guidelines.
Original languageEnglish
Article number110649
JournalDiabetes Research and Clinical Practice
Early online date31 Mar 2023
Publication statusPublished - 1 May 2023

Keywords / Materials (for Non-textual outputs)

  • Antidepressant medication
  • Antipsychotic medication
  • Diabetes complications
  • Diabetes mellitus
  • Diabetes outcomes
  • Systematic review


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