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Can antidepressants affect blood sugar levels?

Thursday, 08 July 2010
Answered by: Dr Sameer Malhotra
Head, Division of Psychiatry and Psychotherapy, Fortis Hospital, New Delhi
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Q. I am a 21 years old male suffering from obsessive compulsive disorder (OCD) for the last 10 years. I also have had social phobia and becomes very nervous and even avoid meeting people or going out. I believe this might be social anxiety disorder. There is family history of depression also. I have taken Fludac for about a week. Earlier, I used to be overweight and had developed insulin resistance. I have read somewhere that antidepressants increase blood sugar level. Please advise.

A.  We all have our strengths and weaknesses. What makes us strong is our ability to accept our problems and trying to find a solution to them.

You have mentioned features of anxiety spectrum disorders including social phobia and OCD, since the last 10 years. There is also a family history of depression. You have taken (serotonin specific re-uptake inhibitor) SSRI (Fluoxetine) for just about a week. Please note that SSRI antidepressants are associated with lowering of blood sugar levels in some patients. However SSRIs are quite commonly prescribed for OCD and social phobias in patients with diabetes. It is recommended that on SSRIs, the blood sugar levels should be monitored in the population with diabetes / impaired glucose control.

Please note that antidepressant medications take about 2 weeks to begin their antidepressant effect and the peak response is usually observed between 4-6 weeks of initiating therapy. Since you stopped the medication within one week of starting it, the response was hardly visible. Also note that SSRI treatment during the initial phase may be associated with some anxiety symptoms or restlessness and it is preferable to initiate these under the cover of low dose anti-anxiety agents under a psychiatrist's supervision. Alongside, relaxation sessions, positive affirmations, cognitive behaviour therapy, graded exposure and exercises can also enhance self confidence. I suggest endocrinology and psychiatric assessment and regular reviews.

A.  We all have our strengths and weaknesses. What makes us strong is our ability to accept our problems and trying to find a solution to them.

You have mentioned features of anxiety spectrum disorders including social phobia and OCD, since the last 10 years. There is also a family history of depression. You have taken (serotonin specific re-uptake inhibitor) SSRI (Fluoxetine) for just about a week. Please note that SSRI antidepressants are associated with lowering of blood sugar levels in some patients. However SSRIs are quite commonly prescribed for OCD and social phobias in patients with diabetes. It is recommended that on SSRIs, the blood sugar levels should be monitored in the population with diabetes / impaired glucose control.

Please note that antidepressant medications take about 2 weeks to begin their antidepressant effect and the peak response is usually observed between 4-6 weeks of initiating therapy. Since you stopped the medication within one week of starting it, the response was hardly visible. Also note that SSRI treatment during the initial phase may be associated with some anxiety symptoms or restlessness and it is preferable to initiate these under the cover of low dose anti-anxiety agents under a psychiatrist's supervision. Alongside, relaxation sessions, positive affirmations, cognitive behaviour therapy, graded exposure and exercises can also enhance self confidence. I suggest endocrinology and psychiatric assessment and regular reviews.

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