Early life adversity blunts responses to pioglitazone in depressed, overweight adults

Thalia K. Robakis, Kathleen Watson-Lin, Tonita E. Wroolie, Alison Myoraku, Carla Nasca, Benedetta Bigio, Bruce McEwen, Natalie L. Rasgon

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Purpose: Early life adversity is associated with both metabolic impairment and depression in adulthood, as well as with poorer responses to antidepressant medications. It is not yet known whether individual differences in sensitivity to antidiabetic medications could also be related to early life adversity. We examined whether a history of early life adversity affected the observed changes in metabolic function and depressive symptoms in a randomized trial of pioglitazone for augmentation of standard treatments for depression. Purpose: Early life adversity is associated with both metabolic impairment and depression in adulthood, as well as with poorer responses to antidepressant medications. It is not yet known whether individual differences in sensitivity to antidiabetic medications could also be related to early life adversity. We examined whether a history of early life adversity affected the observed changes in metabolic function and depressive symptoms in a randomized trial of pioglitazone for augmentation of standard treatments for depression. Findings: We found that early life adversity significantly impaired the metabolic response to pioglitazone. Effects on depressive symptoms did not reach significance, but nonetheless suggested that pioglitazone could mitigate the depressant effects of childhood adversity, only among those insulin resistant at baseline. Conclusions: We conclude that a history of early life adversity may impair the body's ability to respond to insulin sensitizing pharmacotherapy, and furthermore that its contribution to resistant depression may function in part via the generation of an insulin resistant phenotype.

Original languageEnglish
Pages (from-to)4-9
Number of pages6
JournalEuropean Psychiatry
Volume55
DOIs
StatePublished - Jan 2019
Externally publishedYes

Keywords

  • Neuroendocrinology
  • Other psychopharmacology
  • Unipolar depression

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