How Antidepressants Impact Diabetes

Research shows that some antidepressants may improve blood sugar, while others cause it to spike. Here's what you need to know about medications for diabetes and depression.

Many people with diabetes experience diabetes distress, anxiety, or depression. In turn, depression is linked to chronic conditions like diabetes, high blood pressure, heart disease, arthritis, and more. 

This two-way relationship means that depression is a risk factor for worsening blood glucose, and diabetes is a risk factor for developing depression. Mental health conditions like this are often treated with antidepressants. If you live with diabetes and are taking antidepressants, you might be wondering if (and how) the medication can impact your blood sugar.  

How do antidepressants interact with diabetes? 

Some antidepressants have been shown to raise blood sugar and cause hyperglycemia. Other medications have been shown to lower blood sugar and improve overall glycemic control, though they may also increase the risk of hypoglycemia. Here are a few examples.

Antidepressants that raise blood sugar

• Cymbalta (duloxetine)
• Zoloft (sertraline)
• Remeron (mirtazapine)
• Luvox (fluvoxamine)
• Paxil (paroxetine)

Antidepressants linked to lower blood sugar

• Prozac (fluoxetine)
• Lexapro (escitalopram)
• Celexa (citalopram) 
• Savella (milnacipran)

Many antidepressants may lead to weight gain as a side effect. Luckily, several diabetes medications offer weight loss in addition to reducing blood sugar – think Rybelsus (semaglutide), Trulicity (dulaglutide), and other GLP-1 receptor agonists. Indeed, one study found that GLP-1 agonists may be more beneficial than SGLT-2 inhibitors for people with diabetes who are also taking antidepressants. 

Do antidepressants affect blood sugar?

One study found that adequate and consistent antidepressant treatment was linked to better glycemic control (defined as an A1C of less than 7%) after three years, compared to those who had inadequate treatment. Similar research reported that people taking antidepressants were twice as likely to achieve glycemic control compared to those not on antidepressant medication. This may be because people who are better able to manage their depression are more well-equipped to perform diabetes self-care behaviors. 

On the other hand, some research shows that antidepressants can increase the risk of developing type 2 diabetes and that glucose tolerance improves when patients stop taking antidepressants. Newer studies suggest that the effect of antidepressants on new-onset diabetes is quite small, with a greater risk of it developing with long-term antidepressant use. 

Diabetes and depression: risk factors and treatment 

Age may be a key risk factor for depression among people with diabetes; research shows people with youth-onset type 2 diabetes have a higher risk of depression. 

Likewise, a report from the Substance Abuse and Mental Health Services Administration (SAMHSA) found that teens have a higher risk for depression. If your teen with diabetes is struggling with mental health issues, here are some tips for discussing it with them. 

Treatment for depression may involve medication, therapy, and stress-relief techniques. Research suggests that physical activity may also improve depression in people with diabetes. Newer treatments, such as chatting with a virtual assistant, are also being studied. If you have questions or concerns about antidepressants and diabetes, consult with your healthcare team.

There are also many mental health resources available. To find support near you visit: 

• American Diabetes Association: ADA has a searchable database for therapists who work with adults and children, searchable by zip code and telehealth providers.
• Psychology Today: Use their searchable database by typing in your zip code and provider type. You can also search for therapists who list diabetes in their business name and those near you who specialize in chronic illness issues. 
• Behavioral Diabetes Institute: A California-based nonprofit focused on tools to help manage the psychological demands of diabetes.
• 988 National Suicide & Crisis Hotline
• National Alliance on Mental Illness