Section - Quick Takes

02. Antidepressant Use During Pregnancy and the Risk for Gestational Diabetes: A Systematic Review and Meta-Analysis

Published on May 1, 2023 Certification expiration date: May 1, 2026

James Phelps, M.D.

Research Editor - Psychopharmacology Institute

Key Points

Studies reviewed herein suggest that antidepressants may cause diabetes.
Insulin resistance is associated with treatment resistance; overcoming it with metformin improved depression scores in 1 randomized trial in bipolar depression.
Quantifying antidepressant-associated gestational diabetes is one way to further examine causation, but even with large numbers, certainty is hard to establish.

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Text version

Do antidepressants cause gestational diabetes in women who are pregnant? Well, wait a minute, bigger question: Do antidepressants cause diabetes, period, in anyone?

Hi! Jim Phelps here for the Psychopharmacology Institute. Maybe I’ve been asleep, but I’ve not heard of this one. We know from painful experience that we can cause diabetes with atypical antipsychotics. Even just insulin resistance, not overt diabetes, is associated with poorer outcomes, well, at least in bipolar depression. For example, in a recent study by Cynthia Calkin and colleagues, metformin had an antidepressant effect in patients with bipolar depression and insulin resistance but that antidepressant effect was only seen in trial participants who reversed their insulin resistance, which interestingly included 1 patient who was on placebo. So, does the same thing happen in unipolar depression, this worsening of mood course when people develop insulin resistance or frank diabetes? There’s a growing literature on this issue.

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03. Risk of Cardiovascular Diseases Associated With Medications Used in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-analysis

Learning Objectives:

Evaluate the efficacy of haloperidol vs placebo for the management of delirium in intensive care units.
Examine the potential relationship between antidepressant use and gestational diabetes.
Evaluate the risk of cardiovascular events associated with medications for attention-deficit/hyperactivity disorder using data from 19 studies.
Examine research on the joint effects of early childhood adversity and cannabis use on white matter integrity.
Evaluate research on the associations between oral contraceptives, antidepressants, and the risks for suicidal behavior and accidents among patients with premenstrual disorders.

Original Release Date: May 1, 2023

Review and Re-release Date: March 1, 2024

Expiration Date: May 1, 2026

Expert: James Phelps, M.D.

Medical Editor: Melissa Mariano, M.D.

Relevant Financial Disclosures:

James R Phelps declares the following interests:

- McGraw-Hill: Royalties

- W.W. Norton & Co.: Royalties

All of the relevant financial relationships listed above have been mitigated by Medical Academy and the Psychopharmacology Institute.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

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This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.