Optimising antidepressant therapy in type 2 diabetes mellitus

Introduction: The co-occurrence of depression and diabetes mellitus, particularly type 2 diabetes, represents a significant challenge in clinical practice due to its impact on both metabolic control and mental health management. Antidepressants, including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs), are commonly used in managing depression, yet their effects on glycaemic control remain complex. Some antidepressants may influence insulin sensitivity, body weight, and glucose metabolism, thereby potentially complicating diabetes management. Literature review: The aim of this review was to examine the pharmacological treatment of depression in the context of diabetes, focusing on the effects of antidepressants on patients’ metabolic profile and clinical outcomes. We also discuss the impact of antidepressant therapy on quality of life, stress levels, and overall emotional well-being in diabetic patients, highlighting both the benefits and risks associated with pharmacological treatments. Results: Given the potential for both therapeutic benefits and adverse interactions, a careful, individualised approach is necessary to optimise treatment strategies for patients coping with both depression and diabetes.