Metabolic Effects of Fluoxetine in Adults with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Placebo-Controlled Trials

Background: The prevalence of obesity and diabetes is increasing dramatically throughout the world. Studies have shown that excess adiposity is a critical predictor of new onset T2DM. This meta-analysis is aimed to assess the metabolic effects of fluoxetine in T2DM. Methods and Findings: Electronic search was conducted in the database Medline, PubMed, EMBASE, and the Cochrane library, from inception through to March 2011. A systematic review of the studies on the metabolic effects of fluoxetine in T2DM was performed. The weighted mean difference (WMD) and its 95% CI were calculated from the raw data extracted from the original literature. The software Review Manager (version 4.3.1) and Stata (version 11.0) were applied for meta-analysis. Five randomized, placebo-controlled trials were included in the meta-analysis. According to WMD calculation, fluoxetine therapy led to 4.27 Kg of weight loss (95% CI 2.58-5.97, P<0.000 01), 1.41 mmol/L of fasting plasma glucose (FPG) decrement (95% CI 0.19-2.64, P = 0.02) and 0.54 mmol/L of triglyceride (TG) reduction (95% CI 0.35-0.73, P<0.000 01) compared with placebo. Moreover, fluoxetine therapy produced 0.78% of HbA1c decrement (95% CI -20.23-1.78). However, this effect was not statistically significant (P = 0.13). Conclusions: Short period of fluoxetine therapy can lead to weight loss as well as reduction of FPG, HbA1c and TG in T2DM.