Effects of the selective serotonin reuptake inhibitor fluoxetine on glucose metabolism: A systematic review.

OBJECTIVES

The metabolic effects of antidepressants should be considered when prescribing antidepressants due to the increasing risk of diabetes, obesity and cardiovascular disease. This study aims to explore the effects of fluoxetine on glucose and lipid metabolism in human body.

METHODS

Studies of the effects of fluoxetine on glucose and lipid metabolism were collected from the PubMed, MEDLINE and Embase databases without limiting the research design. The retrieval spanned between inception and January 2021. The main outcome measures were fasting blood glucose, glycosylated hemoglobin (mainly HbA1c) and body weight.

RESULTS

A total of 24 studies were retrieved, including 20 randomized controlled trials (RCTs), 1 prospective study and 3 case reports. The meta-analysis showed that FBG and HbA1c levels were moderately decreased(MD-0.85[-1.75, -0.13], P = 0.02 and MD-0.55[-1.23, 0.13], P = 0.11 respectively) and body weight was significantly decreased (MD-3.01[-5.58, -0.44], P < 0.00001) with fluoxetine treatment compared with placebo. Both plasma triglyceride (TG) and total cholesterol (TC) levels decreased significantly (P < 0.00001).

CONCLUSION

Fluoxetine had a positive effect on improving blood glucose control in patients with disorders of glucose metabolism and was good for weight management in obese people despite significant heterogeneity between studies.