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Insulin resistance in major depressive disorder and the effects of psychotropic medications

Jennifer S Mason, Heather A Kenna and Natalie L Rasgon*

Major depression is a serious medical condition with an estimated lifetime prevalence rate of 16.6% (32.6–35.1 million) within the USA. High comorbidity exists between major depression and chronic medical conditions, such as Type 2 diabetes, cardiovascular disease and polycystic ovary syndrome. These diseases are, in turn, pathophysiologically linked by a metabolic state of insulin resistance, characterized by hyperinsulinemia, hyperlipidemia and often overweight/obesity. Many common psychiatric medications, such as antidepressants, anticonvulsants and antipsychotics, used in the treatment of major depression are associated with metabolic dysfunction indicative of insulin resistance. This article provides a review of data specific to major depression and insulin resistance, discusses shared healthrelated problems seen in both conditions, and examines adverse side effects of antidepressant and antipsychotic medications used to treat depression.