Comparisons of glucose–insulin homeostasis following maprotiline and fluoxetine treatment in depressed males

Abstract

Background To investigate the effects of antidepressants on glucose–insulin homeostasis, we provided homogenous situation and performed standard procedures to assess the interactions of antidepressants and glucose regulation during hospitalization. Methods Twenty-three non-diabetic depressed males were recruited and assigned to two groups based on the antidepressants received (maprotiline n = 11, fluoxetine n = 12). The severity of depression was evaluated using a 21-item Hamilton depression rating scale (HAM-D). Before and after the 4-week treatment, participants underwent 75-g oral glucose tolerance test (OGTT) and frequently sampled intravenous glucose tolerance test (FSIGT). Insulin sensitivity ( S I), glucose effectiveness ( S G), acute insulin response (AIR), and disposition index (DI) were estimated using minimal model method. Results The HAM-D scores were reduced significantly ( P < 0.005) after antidepressant treatment. Following maprotiline treatment, the body weight and BMI were significantly increased ( P = 0.02). Individuals treated with maprotiline displayed a significantly increased AIR (3239 ± 682 vs. 4698 ± 597 pmol; P = 0.04) during the FSIGT. Limitations The sample size was limited. Furthermore, the study was conducted in the early phase of depression-treated course. Conclusions The results suggest that the β-cell function is hyperbolic in order to offset the insulin resistance following maprotiline treatment. Our findings imply that norepinephrine reuptake inhibitor (NRI) antidepressants might attenuate insulin sensitivity.