[Diabetes and depression are frequent comorbidities. They are a heavy burden by themselves, however, as comorbidities increase additionally the number of diabetes-related complications, morbidity, and mortality. In the background of interrelations, there are both well-known and hypothetical mechanisms. The aim of the present review is to outline these interrelations between antidepressants and diabetes and to discuss the effect of medications on carbohydrate metabolism respectively. Antidepressant treatment on the one hand may improve mood, cognitive function and medication adherence leading to an improved glucose metabolism, on the other hand through their metabolic side effects, they may worsen carbohydrate metabolism. Concerning metabolic side effects, selective serotonin reuptake inhibitors are the safest, while tricyclic antidepressants and monoamine oxidase inhibitors should be administered under close monitoring. Serotonin and noradrenaline reuptake inhibitors may deteriorate glycaemic control via increased noradrenergic activation. Novel antidepressants, however, have a neutral or positive impact on glycaemic measures. Screening for and temporally adjusted treatment of depression may decrease the risk of comorbidities generated complications. While caring for diabetic patients with depression, one should consider metabolic side effects of antidepressants and close monitoring of carbohydrate metabolism.]
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