Fluoxetine and Blood Glucose Control in Adolescents with Major Depression and Insulin-Dependent Diabetes Mellitus

Abstract

Depression is relatively common in patients with insulin-dependent diabetes mellitus (IDDM), but its pharmacotherapy is complicated by reports of hypoglycemia, hypoglycemic unawareness, and hyperglycemia in association with usage of tricyclic antidepressants. Seven adolescents with IDDM were evaluated for diabetic control for 1 week before and 2 weeks following the initiation of treatment with fluoxetine (20 mg daily). No significant changes in blood glucose levels or daily insulin requirements were noted during the initiation of fluoxetine treatment. Despite the small number of patients and brief follow-up, these preliminary findings suggest that fluoxetine might not aggravate blood glucose control during the initial phase of antidepressant treatment. Before fluoxetine is viewed as preferable to tricyclic antidepressants for treating adolescents with depression and comorbid diabetes, controlled studies are needed to assess acute and chronic changes in blood glucose control in adolescents with IDDM, as well as non-insulin-dependent diabetes mellitus, receiving fluoxetine.