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Outcomes of Depression Drug Treatment Affected by Diabetes

Diabetes complications, pain found to predict poor response to antidepressants

THURSDAY, March 25 (HealthDay News) -- The effectiveness of medical treatment for depression in type 2 diabetes patients is adversely affected by diabetes-related complications, pain and other factors, according to research published in the March issue of Diabetes Care.

Ryan J. Anderson, of the Washington University School of Medicine in St. Louis, and colleagues conducted a pooled analysis of data from two published trials to determine the response to antidepressant medications (bupropion and sertraline) in 387 adults with type 2 diabetes. The researchers assessed several outcomes, including improvement, response, partial remission, and remission, and then evaluated potential predictors of each, including age, race, sex, initial Beck Depression Inventory (iBDI), treatment used, family history of depression, extant diabetes complications (eDC), and A1C level.

The researchers found 85.3 percent of the patients improved, 59.9 percent had a response, 53.5 percent experienced partial remission, and 46.3 percent had full remission. Among the independent predictors, eDC was a predictor for no improvement; sertraline treatment, eDC, and younger age were predictors for non-response; sertraline treatment, eDC, and higher iBDI were predictors for not achieving partial remission; and younger age and higher iBDI were predictors for not achieving full remission. Among patients for whom pain data were available, higher pain scores predicted non-response and failure to achieve full or partial remission.

"In patients with type 2 diabetes, poor initial response to antidepressant medication is predicted by multiple factors. Auxiliary treatment of pain and impairment may be required to achieve better outcomes," the authors write.

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