ABSTRACT
Background: this study was designed to compare the effects of fluoxetine and imipramine on fasting blood glucose [FBG] in patients with major depressive disorder
Methods: non-diabetic patients, with major depressive disorder [based on DSM-IV criteria] entered this randomized, double - blind study. Patients did not receive any medication affecting serum FBG levels at least for 2 weeks prior to the initiation of the study. Patients were assigned to receive 20 to 40 mg/day of fluoxetine or 75 to 200 mglday of imipramine for 8 weeks. Benzodiazepines were allowed when needed for anxiety, agitation or sleep. Pregnant women and patients with diabetes mellitus, and history of major heart diseases were excluded from this study. Additionally, none of the patients should have received electroconvulsive therapy [ECT] within 6 months prior to initiation of the antidepressants. FBG levels were measured at the initiation of study as well as 4 and 8 weeks after starting antidepressants
Results: nineteen patients in the fluoxetine and 24 patients in the imipramine groups completed the study. In the fluoxetine group, FBG level was decreased from 88.5 mg/dL [baseline] to 85.0 mg/dL at week 4 [P=0.73], and to 79.8mg/dL at week 8 [P<0.001]. On the other hand, in the imipramine group, FBG level was increased from 86.96 mg/dL [baseline] to 89.71 mg/dL at week 4 [P=0.079], and to 96.90 mg/dL at week 8 [P<0.001]
Conclusion: this 8-weeks study showed that FBG levels may decrease in depressive patients receiving fluoxetine and may increase in those patients treated with imipramine. Therefore, it is suggested to measure and monitor FBG before initiation and during treatment with fluoxetine and imipramine