Do depressed patients with diabetes experience more side effects when treated with citalopram than their counterparts without diabetes? A STAR*D study

Objective: Diabetes mellitus (DM) is often comorbid with major depressive disorder, yet the impact and types of side effects experienced by patients with DM receiving antidepressant treatment have not been examined. This study examined antidepressant treatment side effects in depressed patients with and without DM to determine whether side effects differed between groups. Method: From July 2001 through April 2004, the Sequenced Treatment Alternatives to Relieve Depression study enrolled 2,876 outpatients with DSM-IV major depressive disorder from primary and psychiatric care settings. The current study compared participants with and without DM regarding frequency, intensity, and burden of side effects-using the Frequency, Intensity, and Burden of Side Effects Rating (FIBSER)-and types of side effects experienced when treated with citalopram (12-14 weeks, 20-60 mg/d). Results: There was no statistically significant difference in the maximum rating of side effects during treatment between participants with and without DM. At the last clinic visit, participants with DM reported fewer and less intense side effects and less impairment from side effects than those without DM (after adjustment for confounding effects of age, race, Hispanic ethnicity, employment status, family history of depression, anxious depression, atypical depression, age at first major depressive episode, and length of illness). However, those with DM had more side effect symptoms consistent with the diagnosis of DM (eg, blurred vision and tremors). Conclusions: Participants with DM reported experiencing side effects at lower rates than those without DM. After statistical adjustment, the groups did not differ significantly regarding types of side effects experienced.