An observational study of the effect of escitalopram and etizolam in type 2 diabetes mellitus patients with depression

Jill Mathews, Suresh V. Dange, Angana Dutta, Abhijeet V. Tilak, Shrikrishna S. Shende, Sayan Das


Background: Past decades have witnessed a rapid rise in the prevalence of diabetes mellitus; estimated to affect 415 million adults worldwide and 69.1 million adults in India. There has been an increased prevalence of diabetes associated depression, which can aggravate the symptoms of depression and diabetes associated complications. Use of tricyclic antidepressants (TCA) can disturb the glycemic control. Escitalopram is a selective serotonin reuptake inhibitor (SSRI) and Etizolam is a new safe antianxiety agent. The objective of this study was to study the prevalence of depression and anxiety in type 2 diabetes mellitus patients and to assess the efficacy of escitalopram and etizolam in the treatment of depression and/or anxiety in type 2 diabetes mellitus patients.

Methods: Total 125 patients diagnosed with type 2 diabetes mellitus with fulfilling the inclusion and exclusion criteria were included in the study. Informed written consent was obtained from the patients willing to participate in the study. They were screened for the presence of depression with the help of PHQ-9. Their demographic features were recorded and initial laboratory investigations done. Haemogram, blood sugar level - fasting (BSL-F) and postprandial (PP), serum alanine transferase (ALT), serum creatinine and Urine routine analysis. Patients were started on Escitalopram (10 mg) + Etizolam (0.5 mg) daily for 30 days and others were not treated and acted as control; keeping the management of diabetes mellitus unchanged for all. Laboratory investigations were repeated after 30 days.

Results: The prevalence of depression with/without anxiety was 35.2%. 51 patients treated with Escitalopram + Etizolam improved clinically and biochemically. There was a significant (P < 0.05) improvement in BSL-F and PP and HbA1C in patients treated with Escitalopram + Etizolam.

Conclusions: Prevalence of depression among type 2 diabetes mellitus was found to be 35% in this study. Fifty one patients treated with escitalopram + etizolam improved clinically as well as biochemically. There was significant improvement in BSL-F, BSL-PP and HbA1c. Escitalopram may be considered as antidepressant of choice in such cases.


Diabetes mellitus and Depression, Etizolam, Escitalopram

Full Text:



Cho NH, Whiting D, Forouhi N, Guariguata L, Li R, Narayan V. IDF Diabetes Atlas [e-book]. 7th ed. Brussels (Bel): International Diabetes Federation; 2015. Available at Assessed on 9 June 2016

Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047-53.

Anderson BJ, Mansfield AK. Psychological issues in the treatment of diabetes Ch.23 in Joslins Diabetes Deskbook 2007 ed. Beaser RS pub. joslin Diabetes Center, Boston; 2007:641-660.

Ciprianti A, Santilli C, Furukawa TA, Signoretti A, Nakagawa A, McGuire H, et al. Escitalopram versus other antidepressive agents for depression. Cochrane Database of Systematic Reviews. 2009;2:CD006532.

Ryan J, Anderson BA, Freedland KE, Clouse RE. The prevalence of comorbid depression in adults with diabetes. Diabetes Care. 2001;24(6):1069-78.

Dhavale HS, Panikkar V, Jadhav BS, Ghulghule M, Agari AD. Depression and diabetes: impact of antidepressant medications on glycaemic control. JAPI. 2013;61(12):896-9.

Polonsky WH. Understanding and treating patients with diabetes burnout. In B Anderson and R Rubin (Eds.) Practical Psychology for Diabetes Clinicians. Alexandria, VA: American Diabetes Association; 2002:219-228.

Sridhar GR, Madhu K. Depression and psychological stress in diabetes mellitus, Novo Nordisk Diabetes Update; 2002:87-92.

Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian Scenario. Indian J Med Res. 2007;125(3):217-30.

Bhattacharya R, Shen C, Wachholtz AB, Dwibedi N, Sambamoorthi U. Depression treatment decreases healthcare expenditures among working age patients with comorbid conditions and type 2 diabetes mellitus along with newly diagnosed depression. BMC Psychiatry. 2016;16(1):247.

Cleal B, Panton UH, Willaing I, Holt RI. Diabetes and depression in Denmark 1996-2010: National data stratified by occupational status and annual income. Diabet Med. 2016. doi: 10.1111/dme.13187.