The antidepressant sertraline may reduce the risk of depression and increase the period of time between episodes of depression in patients with diabetes.

One of every four patients with diabetes experiences clinical depression.

Depression can reduce quality of life and the ability to function and increase the risk for high blood sugar levels, diabetes-related complications and death.

Treatment with antidepressant medications and psychotherapy has been shown to be effective, but only in the short term. In previous studies, one in seven patients with diabetes developed recurrent depression that did not respond to treatment and their blood sugar levels generally increased, placing them at a higher risk of complications associated with their diabetes.

Patrick J. Lustman, M.D., Washington University School of Medicine, St. Louis, found that patiets taking sertraline were significantly less likely to develop an additional episode of depression.

After one year, 65.8 percent of the patients taking sertraline remained in remission from their depression, compared with 47.9 percent of those taking placebo.

The amount of time that passed before depression recurred in one-third of the patients increased from 57 days among patients receiving placebo to 226 days among those taking sertraline.

“Using data available at the one-year point, the number needed to be treated was six patients, i.e., it would be necessary to treat six patients to spare one patient from depression recurrence,” the authors write.

Depression is increasingly understood as a recurrent and debilitating disease, especially for those with diabetes, the authors write. Physicians suspect that the more time an individual spends depressed, the greater the risk for diabetic complications and death.

“Our study establishes a clear benefit of sertraline for prevention of depression recurrence in patients with diabetes,” they conclude.

“Sertraline lengthened the depression-free interval of maintenance and did not interfere with glycemic improvement achieved during the recovery phase. Treatment with sertraline is relatively simple, safe and widely available, and although it is not curative, it offers patients with diabetes a potentially viable method for ameliorating the suffering, incapacity and burden associated with recurrent depression.”