EVALUATING THE NEUROENDOCRINE AND METABOLIC IMPLICATIONS OF SERTRALINE THERAPY IN DIABETIC PATIENTS WITH SEVERE DEPRESSION

Abstract

Background: Depression and diabetes mellitus are chronic, interlinked conditions that frequently coexist and adversely affect each other’s course and prognosis.

Objective: To evaluate the neuroendocrine and metabolic implications of sertraline therapy in diabetic patients with severe depression, focusing on changes in glycemic control, lipid profile, and serum cortisol levels.

Methodology: A cross-sectional analytical study was conducted at Tertiary care hospital from December 2023 August 2024. A total of 205 diabetic patients diagnosed with severe depression were included. Patients aged 30–65 years with type 2 diabetes mellitus and severe depression (diagnosed according to DSM-5 criteria, HDRS score ≥23) who had been on sertraline monotherapy for at least six weeks were enrolled using non-probability consecutive sampling.

Results: The mean age of participants was 51.3 ± 8.6 years; 57.1% were female. Mean fasting glucose and HbA1c were 141.6 ± 33.5 mg/dL and 7.8 ± 1.2%, respectively, while elevated serum cortisol (>18 µg/dL) was observed in 34.6% of patients. A significant positive correlation was found between the duration of sertraline therapy and serum cortisol (r = 0.32, p = 0.01) as well as HbA1c (r = 0.21, p = 0.04), indicating mild worsening of glycemic control with prolonged therapy. Lipid parameters showed no significant association with treatment duration (p > 0.05).

Conclusion: It is concluded that sertraline therapy in diabetic patients with severe depression may cause mild elevations in HbA1c and cortisol levels with prolonged use, reflecting modest neuroendocrine and metabolic effects. However, no significant adverse impact on lipid metabolism was observed.