Table 3.

Psychopharmacological interventions

Reference	Study Design	Depression Entry Criteria	M(SD) Baseline HbA1c levels	Enrolled/Completed	Antidepressant/Dosage/Duration	Depression Measures	Significant Depression Outcomes	Significant Health/Glucose Outcomes	Methodological Characteristics
SSRIs
Lustman et al., 2000	Double-blind RCT of fluoxetine or placebo	DIS MDD HDRS or BDI >= 14	8.4 (1.7)% fluoxetine group, 8.6 (1.6)% placebo group	60/54	Fluoxetine 20-40mg 8 weeks	BDI HDRS	Greater reduction in BDI (-14 v. –8.8, p=.03) and HDRS (-10.7 v. –5.2, p=.01) score in fluoxetine than placebo	HbA1c improved non-significantly (p=.13) more in fluoxetine (-.4%) than placebo (-.07%)	Double-blind placebo-controlled RCT with no follow-up interval, completer analyses, age 21-64, MDD inclusion criterion, type 1 or 2, HbA1c outcome measure
Lustman et al., 2006	Double-blind RCT of sertraline or placebo	HDRS>=16 or BDI >=14 initially; BDI<=9 for 2 mos.	8.2 (1.7)%	152/130	Sertraline 50-200mg 12 mos	BDI	Patients in sertraline group less likely to relapse (HR=.51, p=.01)	HbA1c level did not differ between groups	Double-blind placebo-controlled RCT with 1 year follow-up interval, completer analyses, age 18-80, type 1 or 2, MDD inclusion criterion, HbA1c outcome measure
Paile-Hyvarinen et al., 2003	Single-blind RCT of paroxetine or placebo	MADRS 2.5-12	7.5 (.8)% in paroxetine group, 6.9 (.4)% placebo group	15/13	Paroxetine 20mg 10 weeks	MADRS BDI	No difference in BDI or MADRS between groups	HbA1c improved non-significantly (p=.08) more in paroxetine (-.44%) than placebo (-.07%)	Single-blind placebo-controlled RCT design with no follow-up interval, ITT analyses, post-menopausal women over 50, type 2, mild depressive symptoms, HbA1c outcome measure,
Paile-Hyvarinen et al., 2006	Double-blind RCT of paroxetine or placebo	<= 6 sxs of MDD on interview	8.5 (0.9)% paroxetine group, 8.7 (1.3)% placebo group	49/37	Paroxetine 20mg 6 months	HADS	No significant difference in HADS depression	At 3 mos, but not 6 mos, HbA1c was significantly (p=.018) lower in paroxetine group (7.9) than placebo (8.5)	Double-blind placebo-controlled RCT design with 6-month follow-up interval, completer analyses, age 50-70, type 2, mild depressive symptoms, HbA1c outcome measure
Amsterdam et al., 2006	Open-label	SCID MDD, HDRS>=16	Not reported	17/14	S-citalopram 10-20mg up to 16 weeks	HDRS	Significant reduction in HDRS score	Non-significant reduction in HbA1c	Open-label uncontrolled trial with no follow-up, pre-post completer analyses, age 18 or over, MDD diagnosis, type 1 or 2, HbA1c outcome measure
Gulseren et al., 2005	Double-blind RCT of paroxetine or fluoxetine	SCID MDD, HDRS>=16	6.9 (1.2)% paroxetine group, 6.9 (1.7)% flouxetine group	23/20	Paroxetine, fluoxetine 20-40mg 12 weeks	HDRS	Both groups had significant reduction in HDRS score	Flouxetine group had non-significant reduction in HbA1c	Double-blind RCT design with no follow-up or control condition, pre-post completer analyses, MDD inclusion criterion, type 2, HbA1c outcome measure
Tri-cyclics
Lustman et al., 1997	Double-blind RCT of nortriptyline or placebo	DIS MDD	11.8 (2.9)% nortiptyline group, 11.6 (3.1)% placebo group	35/28	Nortriptyline 50-150mg 8 weeks	BDI	Significantly greater (p=.03) reduction in nortriptyline group (-10.2) than placebo group (-5.8)	No difference in HbA1c	Double-blind placebo-controlled RCT with no follow-up interval, completer analyses, age 21-65, type 1 or 2, MDD criterion, HbA1c outcome measure
Other
Lustman et al., 2007	Open-label buproprion	DIS MDD	8.3 (2.0)%	93/75	Buproprion 150-450mg 10 weeks	BDI	84% depression remitted Reduction in depression severity predicted HbA1c	-.5% reduction in HbA1c levels	Open-label trial with no comparison group and 4-month follow-up interval, pre-post completer analyses, age 18-80, type 2, MDD criterion, HbA1c and other physiological outcome measures