Mirtazapine is known to induce
weight gain and possibly leads to exacerbation of diabetic profiles. However, many cases of diabetic patients, who complained of
insomnia and depression, were treated with
mirtazapine in the clinical situations. Thus, this study aimed to assess any negative effects that treatment with
mirtazapine may incur in diabetic patients.This study included 33 patients enrolled in naturalistic diabetes treatment that had also been diagnosed with depression and prescribed
mirtazapine for at least 6 months. Another 33 diabetic patients who had not taken any psychiatric medicines were included as a control group. Body mass index, fasting plasma
glucose, HbA1c, total
cholesterol,
triglyceride levels,
high-density lipoprotein, and
low-density lipoprotein were assessed at baseline, 3 months, and 6 months.The dose of
mirtazapine at baseline was 24.3 ± 14.0 mg/d in the
mirtazapine group, and the 2 groups did not differ in any baseline characteristics except for total
cholesterol levels. Body mass index increased in both groups, and the change in the
mirtazapine group (1.0 ± 0.6 kg/m) was significantly greater than that in the control group (0.3 ± 0.4 kg/m, P < 0.001) at 6 months. Only the control group exhibited a decrease in fasting plasma
glucose, whereas both groups showed a decrease in HbA1c,
low-density lipoprotein, and total
cholesterol, an increase in
high-density lipoprotein, and no change in
triglyceride levels. None of the differences between the groups were statistically significant.In conclusion,
mirtazapine increased the
weight gain of diabetic patients; however, other diabetic and
lipid markers generally did not worsen during the 6-month treatment period. These results suggest that, at least in the short term,
mirtazapine is safe for diabetic patients in a stable state and are undergoing appropriate diabetic treatment.